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Our tele-3D-computer assisted remote surgical procedures: real time transfer of live video image in parallel with volume rendered operative field models

One of the main objectives of our project named 3D C-FESS and Tele-3D-C-FESS (supported by an unrestricted grant provided by the Croatian Ministry of Science, No. 3-01-543/96) was to design a computer assisted 3D-approach in presurgical planning, intraoperative guidance and postoperative analysis of anatomical regions of the nose and paranasal sinuses. The idea was born in the early ‘ 90s, and our first operation of this kind was done in May 1994. Such an extremely powerful approach should allow a better insight into the operating field including significantly greater safety of the procedure itself. Using our own approach in computer assisted functional endoscopic sinus surgery, we were able to "look inside" the patient, during the real surgical procedure. Telesurgery, as a specific part of telemedicine, consists of two or more operating rooms connected with a computer network. Through this network two encoded live video signals from endo-camera and operating room camera are transferred to other remote locations involved in the telesurgery/consultation procedure. Our telesurgery approach allows surgeons not only to see and to transfer video signals, but also to transfer 3D computer models and surgical instrument movements with image/3D-model manipulations, all together, in real time during the surgery. We use JPEG and MPEG2 encoders and decoders, ATM communication equipment, graphic workstations, 3D digitizers and standard endoscopic surgical instruments. The new video encoders using MPEG2 standards and ATM computer networks using inverse multiplexing, greatly improve the safety of surgical procedures, especially in endoscopic surgery. The best results are obtained using ATM-OC3 technologies, with the most acceptable price-performance using inverse multiplexing method across 4-8 E1 lines.

Telemedicine; 3D; computer assisted surgery; real time; live video image; volume rendering

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