Marescaux J, Mutter D, Soler L, Vix M, Leroy J
IRCAD-EITS et chirurgie digestive et endocrinienne, chirurgie A, hôpitaux universitaires de Strasbourg, France.
Chirurgie. 1999 Jun;124(3):232-9. doi: 10.1016/s0001-4001(99)80088-9.
The advent of new computer technologies can appear as a revolution in surgical teaching, as well as in the planing and realization of surgical procedures. The introduction of a camera into the body of a patient, allowing the visual display of the operative procedure through the use of a miniaturized camera, constitutes the greatest change that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution also predicts further changes: the development of telecommunication devices applied to medicine (tele-education, tele-training, tele-mentoring, tele-proctoring and tele-accreditation), constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of tele-presence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery at Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realization of international multi-site video conferences between surgeons. The WEBS project created the first virtual university concept by placing surgical techniques at the surgeon's disposal through the Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows the development of the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University framework, and to conceive teaching on a world-wide level, offering the practitioner unimaginable possibilities of formation, training and the planning of surgical procedures.
新计算机技术的出现对外科教学以及外科手术的规划与实施而言,似乎是一场革命。将摄像头引入患者体内,借助微型摄像头实现手术过程的可视化展示,这是本世纪末外科领域所经历的最大变革:微创手术诞生了。这场革命还预示着更多变化:应用于医学的电信设备(远程教学、远程培训、远程指导、远程监考和远程认证)的发展,构成了网络手术或虚拟现实的基础,使远程临场和远程操作的概念得以融合。这些新概念是在斯特拉斯堡的欧洲远程外科学院研发出来的。TESUS项目通过实现外科医生之间的国际多站点视频会议,开发了手术图像的使用和数据传输。WEBS项目通过互联网将手术技术提供给外科医生,创造了首个虚拟大学概念。HESSOS项目将虚拟现实用作手术模拟系统。MASTER项目推动了远程遥控概念的发展。现在,有可能突破大学的有限框架进行外科教学,并在全球范围内构思教学,为从业者提供了在手术技能培养、训练和手术规划方面难以想象的可能性。