engleski

Telemedicine assisted surgery : Tele-3D-Computer assisted surgery in Rhinology

The use of minimally invasive surgical methods such as FESS and Tele-FESS has imposed the need of as reliable as possible preoperative imaging of the spatial anatomic relationship in the respective region. In the region of paranasal sinuses, such an image is of paramount importance for the surgeon or tele-expert-surgeon because of the proximity of intracranial structures and limited operative field layout hampering spatial orientation during the operative procedure. During our pilot projects, 3D-C-FESS and Tele-3D.-C-FESS, we used several standards to encode live video signals in telesurgery, such as M-JPEG, MPEG1 and MPEG2. It has been definitely concluded that MPEG2 streams, without audio, have the best picture quality for the operating field/endo camera. For conferencing/consultation cameras used between two or more connected sites during the surgery, we used JPEG and MPEG1 stream with audio. Operating rooms were connected using several computer network technologies with different bandwidths, from T1, E1 and multiple E1 to ATM-OC3 (from 1Mb/s to 155Mb/s). For computer communications using X-protocol for image/3D-models manipulations, we needed an additional 4Mb/s of bandwidth, instead of the 1Mb/s when we used our own communication tools for the transfer of surgical instrument movements. The bandwidth for the transfer in one direction of one MPEG2 stream without audio and one MPEG1 with audio was about 10MB/s

telemedicine assisted surgery; telesurgery; 3D; computer assisted surgery; rhinology

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