The actual problems with live demo surgeries Specific way of - - PDF document

The actual problems with live demo surgeries

Specific way of teaching and exchanging of the experiences in the Medicine

Jiri Navratil1, Sven Ubik1,Pavel Peciva2

1 CESNET a.l.e. Zikova 4, Prague, 16000 Czech Republic 2Krajska Zdravotní a.s., MNUL, Socialni pece 3316, Usti nad Labem, 40011 Czech Republ

The 6th Asia Telemedicine Symposium

December 14th, 2012

Fukuoka, Japan

• Connects all universities and research organization in the

Connects all universities and research organization in the country and provide them IT services country and provide them IT services

• Supports big user communities as Physicists, Medicine,

Supports big user communities as Physicists, Medicine, Biomedicine, Informatics, etc. which are partners in large Biomedicine, Informatics, etc. which are partners in large International projects. International projects.

• Collaborates with Multi Media and Virtual Reality companies

Collaborates with Multi Media and Virtual Reality companies and Movie industry on advanced fast video transmissions. and Movie industry on advanced fast video transmissions. applications applications

CESNET is research organization

sponsored by Ministry of Education CR and academic community

Hodonín Havl.Brod Nové Město na M.

To other hospitals Via EXCHANGE POINT Písek University hospitals (11) Military hospitals (2) Research hospitals (16) via NIX to other hospitals in the regions

CESNET creates an ideal environment for medical collaboration

MNUL

Network connects all Medical Faculties and all large hospitals

• Building

Building „ „last miles last miles“ “ to the hospital facility to the hospital facility

• Providing technical service with needed devices on

Providing technical service with needed devices on the sites (camera, codecs, networking) the sites (camera, codecs, networking)

• Helping with special projection (3D)

Helping with special projection (3D)

• Establish E2E links on requests (from operation room

Establish E2E links on requests (from operation room to conference halls, in frame of the country and also to conference halls, in frame of the country and also internationally) internationally)

Forms of supports to medical communities

GN2

MTI

GLIF – Global Lambda Integrated facility

http://www.glif.is/participants/

Teaching and Exchanging experiences via examples is getting more and more popular

Two basic independent ways:

• Sharing data (video,PDF,etc.) via Internet (MedFaculties + CESNET)

MedFaculties – provide the content CESNET provides the infrastructure and control software Stable application dedicated to students

• Live Surgery transmissions (CESNET + Clinics)

Live Surgeries are requested on medical congresses, annual conferences, etc. usually organized in attractive environments as Spa resorts, famous building in historical towns, concert halls, etc. with no or very weak connectivity ! Main problem: Nearly each event needs special preparation and extra cost. There are several tools which can be used

1) H323 videoconference units (0,5 - 6 Mbps with compression) 2) DVTS (35 Mbps) 3) MVTP-4K (1,5 – 10 Gbps) (codec – high compression Low quality of coloures and grey scale, high latency) Software, no compression, no internal latency Quality defined by the camera FullHD quality, no compression, No internal latency, up to 8 channels, 3D

LiveSurgery

DVTS - Plus

(CERNET application)

Multipoint VC, princip Client-Server, Internet connection

35 Mbps

since 2010

Server MCU

Makito codec MPEG-4 AVC / H.264 video from 352x288 až 1080p (Full-HD) Sending up to 8 destinations with two levels of quality and resolution Maximum bandwidth for stream is 15 Mbps ~ 10 K US

Surgery room 1 Surgery room 2

Camera 1 Camera 2

Video v4

v 1

Management machine with all video signals on 4 windows s v1,v2,v3,v4 (for teacher decisions)

Screen 1 Projector 2

Seminar room

Voice 2

(fro m robot)

Voice1

(microphone.)

ENC1 ENC2 ENC3 ENC4

IP IP IP IP

Video v2 Video v1 Video v3

IP IP IP IP

v 2 v 4 v 3

VLC receiver: v1 | v2 |v3| v4 According to the teacher VLC receiver: v1 | v2 |v3| v4 According to the teacher

mcast

for Questions

Hospital N e t w o r k

Interesting events in 2012

• Usually in the places where is no good network
• There are other limitations as big halls
• The attendees expect some form of show

Always big challenge for organizers

CENS 2012 neurosurgery lessons

2012

CENS 2012 neurosurgery lessons

Robot daVinci HD resolution

HD 3D camera 3D Video unit

F10 AS3D

H323 Video conference Robot da Vinci

MVTP-4k

2 HD videosignals

Left a Right eye

MVTP-4k

3D video - General scenario using MVTP-4K

NETWORK 10Gbps Stereo projector F10AS3D Video from Operation room

ZD101 DLP

http://www.ces.net/project/qosip/hw/mvtp-4k.pdf Modular Video Transport Platform - codec

2 HD videosignals

Left a Right eye

http://www.ces.net/project/qosip/hw/mvtp-4K-v2.pdf

IN: 8x HD-SDI OUT: 8x HD-SDI Network – 10 Gigabit Ethernet MVTP-4K (Modular Video Transfer Platform)

• 2x 4K or 8x 2K/HD
• unlimited distance over

regular Internet

• full-duplex
• embedded audio
• adds less than 1 ms

to networking delay

• output synchronization

without clock source

3D screen videoconference CESNET – SANET Collaboration: daVinchi operation in MNUL to Banska Bystrica Telebridge Ústi nad Labem (CR) – Banská Bystrica (SK) 3D screen videoconference

Cheap passive glasses Problem: expensive projectors Advantage: quantity, large halls 3D projectors

Stereo projector F10AS3D DepthQ PM

unit for conversion from Active to Passive 3D glasses

MVTP-4k

Cheap 3D screens (LG,SAMSUNG,Panasonic) Cheap passive glasses Limitations: for individuals or small lab set ZOF 2012 Zlin’s Eyes Festival

Projection to 3 screens: A,B,C

3D screen A B C

This is 3D Cinema projector

3D video in monoscopic view (without 3D glasses, all is doubled, blurred) left eye view right eye view

Streamed into Internet

XIX congress of GPSSLS at Bratislava (SK)

4 parallel surgeries

Stereo projector F10AS3D DepthQ PM

unit for conversion from Active to Passive 3D glasses

MVTP-4k

2012

3D screen from robot daVinci

Live surgery Moderator 3D screen Internet stream

Interesting events in 2012

Initial phase: Simple projector + expensive active glasses Next step a) Strong projectors + cheap passive glasses - expensive b) Projector + PM to cheap passive glasses - contrast problems New trends with new and cheap technology 3D TV displays (Panasonic, Samsung, LG) + glasses (active or passive) – cheap, very good resolution, Ideal for small labs and professional education Where to go for congresses and symposia ? Back to 2D ?

After 2 years of experiments 2D/3D dilemma

Thank you for attention