Machado MA, Surjan R, Torres MC, Makdissi F

Surg Innov

A Simple Technique to Improve Visibility and Illumination During Robotic Surgery.

In order to improve illumination and visibility during
robotic surgery, we have used a simple trick. The liver is
sutured to the abdominal wall by the gallbladder (if it is
present and about to be removed) and round ligament.
The next step is to cover the liver with clean gauzes in
order to replace the liver background (dark) to a white
and brighter background. The amount of light reflected depends on the smoothness
and color of the surface. White and smooth surface
has the better light reflection. Also, the angle at which the
light strikes the object influences the amount reflected. If
the light strikes the surface of the white background
formed by the combined gauzes at a low angle, reflection
is favored. We use the knowledge of light absorption and
reflection in our favor. Covering the dark liver, we remove
the light absorption that reduce the illumination of the
surgical field. Replacing the dark background by a white
and smooth surface using 3 or 4 gauzes can immediately
improve surgical visibility. This simple technique is routinely used in our robotic
surgical procedures whenever necessary. We recommend
the use of this technique to improve visibility and illumination
during minimally invasive surgeries when a dark
surgical field cannot be improved otherwise.