Klapan I, Simicić Lj, Pasarić K, Vlahusić A, Risavi R, Sruk V, Schwarz D, Barisić J
ENT Department, Zagreb University School of Medicine, Croatia.
J Telemed Telecare. 2002;8(3):125-30. doi: 10.1177/1357633X0200800301.
We have carried out three-dimensional, computer-assisted, functional endoscopic sinus telesurgery. Surgeons at different locations up to 300 km apart could not only see and transfer video images but also transfer three-dimensional computer models and manipulate them in realtime during surgery. Two different approaches were used. In the first telesurgery procedure we used M-JPEG compression and transmitted the data using fibre optic connections (ATM OC-3) at a bandwidth of 155 Mbit/s. In the second telesurgery procedure video images were transmitted over four E1 digital lines, amounting to about 8 Mbit/s of bandwidth, with better compression standards, such as MPEG1 and 2. We found that MPEG2 video compression produced the best picture quality for the operating field and endoscopic cameras. For conferencing and consultation between two or more connected sites during the surgery, we used JPEG and MPEG1 video compression with audio. The main feature of our three-dimensional telesurgery was the use of three-dimensional modelling of the operative field. This is important for emergency surgical interventions. We do not advocate that inexperienced surgeons operate on patients, not even with the guidance of a remote surgeon. However, three-dimensional telesurgery may become very valuable for experienced surgeons in the future.
我们开展了三维计算机辅助功能性鼻内镜鼻窦远程手术。相距达300公里的不同地点的外科医生不仅能够看到并传输视频图像，还能传输三维计算机模型并在手术过程中实时操作它们。采用了两种不同的方法。在第一次远程手术中，我们使用M-JPEG压缩，并通过光纤连接（ATM OC-3）以155 Mbit/s的带宽传输数据。在第二次远程手术中，视频图像通过四条E1数字线路传输，带宽约为8 Mbit/s，并采用了更好的压缩标准，如MPEG1和MPEG2。我们发现MPEG2视频压缩为手术视野和内镜摄像头产生了最佳图像质量。在手术期间，为了两个或更多连接站点之间的会议和会诊，我们使用了带有音频的JPEG和MPEG1视频压缩。我们三维远程手术的主要特点是使用手术视野的三维建模。这对于紧急手术干预很重要。我们不主张没有经验的外科医生为患者做手术，即使有远程外科医生的指导也不行。然而，三维远程手术未来可能会对有经验的外科医生变得非常有价值。
