Manish Dutta, Institute of Liver and Biliary Sciences INSTITUTE OF - - PDF document

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Manish Dutta, Institute of Liver and Biliary Sciences INSTITUTE OF LIVER & BILIARY SCIENCES New Delhi, IN Tele Conference Cart Manish Dutta ILBS Introduction The Institute of Liver & Biliary Sciences (ILBS) has been established

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 1 INSTITUTE OF LIVER & BILIARY SCIENCES New Delhi, IN Tele‐Conference Cart‐ Manish Dutta

The Institute of Liver & Biliary Sciences (ILBS) has been established by the Government of NCT of Delhi as an autonomous institute. The mission of ILBS is to become a dedicated international centre of excellence for the diagnosis, management and advanced training & research in the field of liver and biliary diseases. The first phase of ILBS has 180 hospital beds, 74 of which cater as intensive care (ICU) beds. ILBS is a deemed University and aspires to become a unique model for an academic career both for the national and international students and the faculty.

ILBS ‐ Introduction

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 2 Tele Conference Cart ‐ Requirement

Tele‐conference cart to cater to the Institute’s needs and specialties: 1. To enable live bi‐directional AV communication and provide the ability to present a patient and share images and data with a remote location. 2. To integrate with medical equipments to show their live output along with the camera feed for interaction. 3. Should be self‐contained with small footprint to fit in limited spaces of procedure rooms.

Tele Conference Cart ‐ Requirement

Tele‐conference cart shall be used to demonstrate the following procedures to remote locations: 1. Endoscopy, EUS, Colonoscopy. 2. ERCP, HVPG, TJLB, Interventional radiology. 3. Laparoscopy procedures. 4. Open Surgery and transplant such as kidney and liver.

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 3 Tele Conference Cart ‐ Solution

We have developed a cart with following key components: 1. HD Video Conferencing: Vidyo Codec HD220 and router at Kyushu University is being used for multi party conference with remote participants. 2. Scalar: To convert video inputs from virtually all sources into format compatible with Vidyo for

transmission. Key component of this general

purpose cart. 3. Audio Mixer: To auto mix audio from multiple mics and Vidyo along with functionality of acoustic echo cancellation (AEC).

Since complete Institute has centralised UPS supply, a dedicated UPS for cart was not provisioned.

Tele Conference Cart ‐ Components

1 VC Codec Vidyo HD‐220 2 PTZ Camera Sony EVI‐HD7V 3 Microphone Revolabs HD Dual 4 Audio Mixer with AEC Extron DMP 128 5 Video Switcher Extron DVS 605 6 Speakers Sony SRS‐D5 7 Network Switch Netgear ProSafe 24

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 4 Tele Conference Cart ‐ Procedures Tested

Endoscopy, EUS, Colonoscopy Scope Olympus CLV 180 Pentax epk‐i S‐Video S‐Video ERCP, HVPG, TJLB Floroscopy Vitals Monitor Olympus CLV 180 Shimadzu Philips Olympus CLV 180 VGA VGA S‐Video Laparoscopy Scope C‐Arm Wolf HD Philips BV Pulsera DVI, Svideo Composite

Tele Conference Cart – Under Process

Interventional Radiology Floroscopy Shimadzu VGA Surgery C‐Arm Intraoperative Ultrasound SurgiCam Philips BV Pulsera Profocus 2202 KLS Martin Composite VGA, S‐Video S‐Video, Composite

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 5

H.264 Scalable Video Coding (SVC) protocol for reduced bandwidth requirement Full HD 1080p30 resolution conference Multiple devices such as mobile phone, tablets and notebook can join the conference. (VidyoMobile, VidyoDesktop) Web‐based control via VidyoPortal One HDMI video input for camera and 2 display port for output. Content sharing through separate USB device.

VC Codec ‐ Vidyo HD‐220

Multi Input Scaler, Switcher with Picture in Picture (PIP)

Video Scaler – Extron DVS 605

Multiple standard support Accepts multiple analog inputs

Composite S‐Video Component RGBs VGA

Accepts digital video inputs

HDMI DVI

Wide input resolution range 640x480 to 1920x1200 Web management interface

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 6 Audio Mixer – Extron DMP 128

Audio Digital Signal Processor Digital Matrix Processor with flexible routing and mixing capabilities. 12 mic/line inputs and 8 outputs. Eight channels AEC ‐ Acoustic Echo Cancellation Web management interface

Connection Diagram

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 7 Live HVPG Session at 36th APAN conference

South Korea 20‐08‐2013

HVPG ‐ Requirements

Fluoroscopy UXGA (4:3) 1600 x 1200 Analog‐ VGA Vitals Monitor XGA (4:3) 1024 x 768 Analog‐ VGA PTZ Camera 1080p (16:9) 1920 x 1080 Digital‐ DVI

Video Outputs

Codec 1080p (16:9) 1920 x 1080 Digital‐ DVI Monitors 1080p (16:9) 1920 x 1080 Digital‐ HDMI

Video Input

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 8 HVPG ‐ Solution

2 Vidyo Rooms were created for this conference: Room 1: For showing Floroscopy image along with Vitals Monitor. This was shown continuously throughout the session. Room 2: For showing faculty, procedure interaction and content.

Extron 605

Waveform

VGA VGA VGA HDMI Vidyo HD 220 HDMI DVI Display HDMI

NKN

Mic

Aux Aux Interaction DMP with AEC Aux Control – Room1 Control – Room2 Skype + Coordination Vidyo HD 220 Content Sharing

Room 1 Room 2

Procedure Feed

Fluoroscopy

DVI

PTZ Camera

Aux VGA Procedure output Interaction

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Manish Dutta, Institute of Liver and Biliary Sciences The 7th Asia Telemedicine Symposium, 2013 9 HVPG ‐ Photographs

Human Network ‐ Cooperation between

engineers and medical staff is a key to success.

Testing & preparation are essential.
Remote participant coordination is a must.

HVPG ‐ Conclusion

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