Performing surgical procedures by laparoscopy alters the surgeon’s vision of the surgical site. As opposed to having a direct view, the surgeon visualises the operative space by means of a screen transmitting as accurately as possible images of the working space.

This initially involves creating the primary surgical area, or operative space, which for a digestive surgeon is the abdomen. The creation of this working space is achieved by controlled insufflation of CO2 in the surgical cavity.
Before the image can be transmitted to the screen, it is necessary to brighten the surgical site with a light of a colour temperature similar to white light (6000°K, equivalent to sunlight). The image, picked up by a camera which transforms colours into digital data thanks to Charged Coupled Devices sensors (CCD), can then be restored on a digital screen.

The overall picture quality is evolving rapidly over the years, following the progress of both IT and AV media. The standard in 2018 is a 4K camera coupled with a 4K screen for accurate rendering. Optics are also steadily improving, increasing the picture quality both in terms of brightness and definition. This image will soon be stereoscopic, challenging once more the standards of image-guided surgery.
In this chapter, all elements involved in reproducing the surgical site image are considered so that, using basic technical knowledge, surgeons will be able to make informed decisions when purchasing new equipment. This knowledge will also allow surgeons to understand the causes of malfunctions that can alter the operative image quality, and carry out appropriate remedial action.