Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-Cho Hirosaki, Aomori, 036-8562, Japan.
Committee for Promotion of Remote Surgery Implementation, Japan Surgical Society, Tokyo, Japan.
J Robot Surg. 2024 Jan 11;18(1):9. doi: 10.1007/s11701-023-01792-8.
Assuring communication redundancy during the interruption and establishing appropriate teaching environments for local surgeons are essential to making robotic telesurgery mainstream. This study analyzes robotic telesurgery with telementoring using standard domestic telecommunication carriers. Can multiple carriers guarantee redundancy with interruptions? Three commercial optical fiber lines connected Hirosaki University and Mutsu General Hospitals, 150 km apart. Using Riverfield, Inc. equipment, Hirosaki had a cockpit, while both Mutsu used both a cockpit and a surgeon's console. Experts provided telementoring evaluating 14 trainees, using objective indices for operation time and errors. Subjective questionnaires addressed image quality and surgical operability. Eighteen participants performed telesurgery using combined lines from two/three telecommunication carriers. Manipulation: over 30 min, lines were cut and restored every three minutes per task. Subjects were to press a switch when noticing image quality or operability changes. Mean time to task completion was 1510 (1186-1960) seconds: local surgeons alone and 1600 (1152-2296) seconds for those under remote instructor supervision, including expert intervention time. There was no significant difference (p = 0.86). The mean error count was 0.92 (0-3) for local surgeons and 0.42 (0-2) with remote instructors. Image quality and operability questionnaires found no significant differences. Results communication companies A, B, and C: the A/B combination incurred 0.17 (0-1) presses of the environment change switch, B/C had 0, and C/A received 0.67 (0-3), showing no significant difference among provider combinations. Combining multiple communication lines guarantees communication redundancy and enables robotic telementoring with enhanced communication security.
确保中断期间的通讯冗余,并为当地外科医生建立适当的教学环境,对于将机器人远程手术变为主流至关重要。本研究使用标准的国内电信运营商分析带远程指导的机器人远程手术。多个运营商能否通过中断来保证冗余性?三条商业光纤线将相隔 150 公里的弘前大学和十和田综合医院连接起来。弘前大学使用 Riverfield, Inc. 的设备建立驾驶舱,而十和田综合医院则同时使用驾驶舱和外科医生控制台。专家使用客观指标(操作时间和错误)评估了 14 名学员的远程指导效果。主观问卷则评估了图像质量和手术可操作性。18 名参与者使用来自两个/三个电信运营商的组合线路进行远程手术。操作:超过 30 分钟,每三分钟中断一次并恢复,受试者在发现图像质量或手术可操作性变化时按下开关。完成任务的平均时间为 1510(1186-1960)秒:当地外科医生单独操作的时间和在远程指导监督下(包括专家干预时间)的时间为 1600(1152-2296)秒。两者之间没有显著差异(p=0.86)。本地外科医生的平均错误计数为 0.92(0-3),远程指导教师的平均错误计数为 0.42(0-2)。图像质量和可操作性问卷没有发现显著差异。与通信公司 A、B 和 C 的结果:A/B 组合的环境变化开关按压次数为 0.17(0-1),B/C 为 0,C/A 为 0.67(0-3),表明供应商组合之间没有显著差异。组合多个通信线路可保证通讯冗余,并可实现增强通讯安全性的机器人远程指导。
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