Endoscopic Observation Combined With Video-record Analysis In Level Ⅵ Neck Dissection: A Methodology Research For Anatomy Study In Tracheo-esophagial Groove And Superasternal Fosa

Objective Evaluate the technical feasibility of a research method for anatomy by intro-operative endoscopic observation combined with postoperative video-record analysis in Levelâ…¥neck dissection.Methods 80 papillary micro-carcinoma patients were consecutively selected for the evaluation from July 2008 to December 2009. Anatomic structures in tracheo-esophagial groove and superasternal fosa were studied upon endoscopic view(Camera control unit:Tricam SLâ…¡; Endoscope:Hopkinsâ…¡, Karlstorz Endoscope, Germany), and simultaneously photographed by a digital recorder (DVCAM DSR-PDX10P, Sony, Japan) throughout dissection process. Thereafter, individual DVD files were displayed and specific photos captured (Herosoft v.3500) to evaluate the reduction effects on real anatomy. Efforts were made first to delineating the major quality elements of image, and then, to sieving the possible factors which influence much to them. Relevant adjustable parameters of endoscope system were tested to fulfill the image quality requirements. Photo angles were also assessed to avoid figure distortion.Results (1) The major quality elements of image are color reduction, clearness, layer felling and normal figuration. Correspondingly, factors which influence much to the elements are:â‘ Adjustable parameters of endoscope system, such as lightness, contrast, color saturation of monitor and fixed focus, white balance on camera control unit.â‘¡Photographing angle (between mirror plane and object plane) should also be a definitive factor for disfiguration of the image. (2) Best image reduction of the real anatomy can ideally archived by adjustable parameters-resetting and proper endoscope-holding.Conclusion Image reduction on real anatomy can be archived by currently used endoscope system during Level VI neck dissection. Best image qualities can be archived if the system is properly set and the endoscope is well held. The recorded video and captured pictures are also reliable and useful "data" for further analysis and comparison. And thus, local anatomy research, especially the identification of fine shape and structure in narrow tracheo-esophagial groove and superasternal fosa emerges: intro-operative endoscopic observation combined with postoperative video-record analysis.