Image system allows telesurgical operation

17 Jun 2002

A patient in Bangkok, Thailand, had kidney surgery May 17 in Thailand directed from Johns Hopkins University in the United States.

The telesurgery was performed with doctors stationed in Maryland operating a robotic laparoscope which relayed images in real time.

"It was quick and everything went normally," said Eric Horschman, the director of marketing for Avistar Systems Corporation. Avistar provided the video technology for the procedure.

Horschman noted that the technology allows a surgeon in a remote location to assist on-scene medical personnel who might not be as familiar with the procedure or to allow a less-extensive hospital to receive aid from a hospital with more technology. In addition to allowing procedures to be performed in less technologically advanced areas, the procedure also has the potential to enhance operations on combat wounds at field hospitals.

A sensor was mounted in the electro-cautery device which was part of the laparoscope. Horschman said that the technological breakthrough was the high quality of the video and audio connection, which let multiple personnel in Maryland view the operation.

The video at 30 frames per second was transmitted through a codec (compressor/decompressor) over an ISDN line at 384 kilobits per second. The output was comparable to VHS video.

"It was glitch-free. There were no problems with drop-outs or disconnects," noted Horschman. "The surgeons were really excited with the results and ease and success of the procedure."

Another advantage was that the doctors directing the surgery did not have to be in the same operating room as the surgery itself. This not only allows for remote surgery but also enables both those directing the surgery and those on the scene to work in less crowded conditions.

The system involved a two-way camera, and the doctors at Johns Hopkins University could draw lines or circles on the screen which were transmitted back to Bangkok.

"The key thing that we can really do well is let a surgeon participate in the telesurgery in his office," said Horschman.