engleski

Tele-3D-CAS. Croatian approach

During the telesurgery, the computer with its operative field image allows the surgeon, by means of up-to-date technologies, to connect the operative instrumentarium to spatial digitalizers connected to the computer. Upon the completion of the tele-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself. Using intraoperative records, animated images of the real tele-procedure performed can be designed. By means of computer records labeled coordinate shifts of 3D digitalizer during the surgery, an animated image of the course of operation in the form of journey, i.e. operative field fly-through in the real patient, can be designed. Beside otorhinolaryngology, this has also been used in other fields. The more so, in addition to educational applications, VS offers the possibility of preoperative planning in sinus surgery, and has become a very important segment in surgical training and planning of each individual surgical or telesurgical intervention, not only in the reigon of paranasal sinuses. The complex software systems allow tele-visualization of CT or MRI section in its natural course (the course of examination performed), or in an imaginary, arbitrary course. Particular images can be transferred, processed and deleted, or can be presented in animated images, as it was done during our 1st TS. Multiple series of images can be simultaneously observed in different color tables and at various magnification, with various grades of transparency, observing them as a unique 3D model system. The work with such models allows different views, shifts, cuts, separations, labeling, and animation. The series of images can be changed, or images can be generated in different projections through the volume recorded, as we have showed in our OR. Before the development of 3D spatial model, each individual image or the whole series of images have to be segmented, in order to single out the image parts of interest. Thus, separate models of bones, healthy tissue, affected tissue, and all significant anatomic entities of the operative field are developed. The complete tele-procedure planned can be developed on computer models and a series of animations describing the procedure can be produced. It has become a routine mode of action in a number of centers worldwide when necessary. Comparative analysis of 3D anatomic models with intraoperative finding, in any kind of telesurgery, shows the 3D volume rendering image to be very good, actually a visualization standard that allows imaging likewise the real intraoperative anatomy.

Telemedicine; 3DCAS; Croatian telemedicine

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