Marescaux J, Mutter D, Soler L, Vix M, Leroy J
IRCAD-EITS, Hôpitaux Universitaires de Strasbourg.
Bull Acad Natl Med. 1999;183(3):509-21; discussion 521-2.
The advent of new computer technologies appears as a revolution of surgical teaching, as well as the planning and realisation 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 miniaturised camera constitutes the greatest alteration that the surgical world has experienced at the end of this century: mini-invasive surgery is born. This revolution was announces further changes: the development of telecommunication devices applied to medicine (tele-education, teletraining, telementoring, teleproctoring and tele-accreditation) constitutes the basis of cybersurgery or virtual reality allowing the merging of the concepts of telepresence and telemanipulation. These new concepts were developed at the European Institute of TeleSurgery of Strasbourg. The TESUS project developed the use of surgical images and data transmission through the realisation of international multi-site video conferences between surgeons. The WEBS project created the first Virtual University concept placing surgical techniques at the surgeon's disposal through Internet. The HESSOS project uses virtual reality as a surgical simulation system. The MASTER project allows to develop the concept of distant telemanipulation. It is now possible to face surgical teaching outside of the restricted University frame and to conceive teaching on a world level, offering to the practitioner unimaginable possibilities of formation, training and planning of surgical procedures.
新计算机技术的出现似乎是外科教学以及外科手术规划与实施的一场革命。将摄像头引入患者体内,通过使用小型化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。这场革命预示着进一步的变化:应用于医学的电信设备(远程教育、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,使得临场感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发展起来的。TESUS项目通过外科医生之间的国际多站点视频会议,实现了手术图像的使用和数据传输。WEBS项目创建了首个虚拟大学概念,通过互联网将手术技术提供给外科医生使用。HESSOS项目将虚拟现实用作手术模拟系统。MASTER项目使得远程操作的概念得以发展。现在有可能突破大学的有限框架进行外科教学,并构思全球范围内的教学,为从业者提供手术程序的培训、训练和规划方面难以想象的可能性。