Smith C Daniel, Skandalakis John E
Emory Simulation Training and Robotics (ESTAR), Emory University School of Medicine, Atlanta, GA 30322, USA.
Surg Innov. 2005 Jun;12(2):139-43. doi: 10.1177/155335060501200212.
Remote presence in an operating room to allow an experienced surgeon to proctor a surgeon has been promised through robotics and telesurgery solutions. Although several such systems have been developed and commercialized, little progress has been made using telesurgery for anything more than live demonstrations of surgery. This pilot project explored the use of a new videoconferencing capability to determine if it offers advantages over existing systems. The video conferencing system used is a PC-based system with a flat screen monitor and an attached camera that is then mounted on a remotely controlled platform. This device is controlled from a remotely placed PC-based videoconferencing system computer outfitted with a joystick. Using the public Internet and a wireless router at the client site, a surgeon at the control station can manipulate the videoconferencing system. Controls include navigating the unit around the room and moving the flat screen/camera portion like a head looking up/down and right/left. This system (InTouch Medical, Santa Barbara, CA) was used to proctor medical students during an anatomy class cadaver dissection. The ability of the remote surgeon to effectively monitor the students' dissections and direct their activities was assessed subjectively by students and surgeon. This device was very effective at providing a controllable and interactive presence in the anatomy lab. Students felt they were interacting with a person rather than a video screen and quickly forgot that the surgeon was not in the room. The ability to move the device within the environment rather than just observe the environment from multiple fixed camera angles gave the surgeon a similar feel of true presence. A remote-controlled videoconferencing system provides a more real experience for both student and proctor. Future development of such a device could greatly facilitate progress in implementation of remote presence proctoring.
通过机器人技术和远程手术解决方案，有望实现让经验丰富的外科医生在手术室远程指导其他外科医生。尽管已经开发并商业化了几种这样的系统，但除了手术现场演示外，远程手术在其他方面进展甚微。这个试点项目探索了一种新的视频会议功能的使用，以确定它是否比现有系统具有优势。所使用的视频会议系统是一个基于个人电脑的系统，配有平板显示器和一个连接的摄像头，然后安装在一个远程控制平台上。该设备由一台配备操纵杆的远程个人电脑视频会议系统计算机控制。通过客户端的公共互联网和无线路由器，控制站的外科医生可以操纵视频会议系统。控制功能包括在房间内移动设备以及像头部上下左右转动一样移动平板屏幕/摄像头部分。这个系统（InTouch Medical，加利福尼亚州圣巴巴拉）被用于在解剖学课程的尸体解剖过程中指导医学生。学生和外科医生主观评估了远程外科医生有效监测学生解剖并指导他们活动的能力。该设备在解剖实验室中能非常有效地提供可控且互动的存在。学生们感觉他们是在与人互动，而不是与视频屏幕互动，并且很快就忘记了外科医生不在房间里。在环境中移动设备而不仅仅是从多个固定摄像头角度观察环境的能力，给了外科医生一种类似真实在场的感觉。一个远程控制的视频会议系统为学生和指导者都提供了更真实的体验。这种设备的未来发展可以极大地促进远程在场指导的实施进展。
