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

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 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. The 7th Asia Telemedicine Symposium, 2013 1

Manish Dutta, Institute of Liver and Biliary Sciences 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. The 7th Asia Telemedicine Symposium, 2013 2

Manish Dutta, Institute of Liver and Biliary Sciences 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 The 7th Asia Telemedicine Symposium, 2013 3

Manish Dutta, Institute of Liver and Biliary Sciences Tele Conference Cart ‐ Procedures Tested Endoscopy, EUS, Scope Olympus CLV 180 S ‐ Video Colonoscopy Pentax epk ‐ i S ‐ Video ERCP, HVPG, TJLB Floroscopy Shimadzu VGA Vitals Monitor Philips VGA Olympus CLV 180 Olympus CLV 180 S ‐ Video Laparoscopy Scope Wolf HD DVI, Svideo C ‐ Arm Philips BV Pulsera Composite Tele Conference Cart – Under Process Interventional Floroscopy Shimadzu VGA Radiology Surgery C ‐ Arm Philips BV Pulsera Composite Intraoperative Profocus 2202 VGA, S ‐ Video Ultrasound SurgiCam KLS Martin S ‐ Video, Composite The 7th Asia Telemedicine Symposium, 2013 4

Manish Dutta, Institute of Liver and Biliary Sciences VC Codec ‐ Vidyo HD ‐ 220 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. Video Scaler – Extron DVS 605 Multi Input Scaler, Switcher Multiple standard support Wide input resolution range with Picture in Picture (PIP) 640x480 to 1920x1200 Accepts multiple analog inputs Composite S ‐ Video Component RGBs VGA Web management interface Accepts digital video inputs HDMI DVI The 7th Asia Telemedicine Symposium, 2013 5

Manish Dutta, Institute of Liver and Biliary Sciences 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 The 7th Asia Telemedicine Symposium, 2013 6

Manish Dutta, Institute of Liver and Biliary Sciences Live HVPG Session at 36 th APAN conference South Korea 20 ‐ 08 ‐ 2013 HVPG ‐ Requirements Video Outputs 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 Input Codec 1080p (16:9) 1920 x 1080 Digital ‐ DVI Monitors 1080p (16:9) 1920 x 1080 Digital ‐ HDMI The 7th Asia Telemedicine Symposium, 2013 7

Manish Dutta, Institute of Liver and Biliary Sciences 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. Procedure Feed Room 1 Procedure output Fluoroscopy HDMI VGA VGA Extron HDMI DVI Vidyo Display 605 HD 220 VGA Waveform VGA Interaction Content Sharing NKN Interaction Room 2 PTZ Camera DVI HDMI Control – Room1 Control – Room2 Vidyo Aux HD 220 DMP Aux with Mic AEC Aux Aux Skype + Coordination The 7th Asia Telemedicine Symposium, 2013 8

Manish Dutta, Institute of Liver and Biliary Sciences HVPG ‐ Photographs HVPG ‐ Conclusion Human Network ‐ Cooperation between • engineers and medical staff is a key to success. Testing & preparation are essential. • Remote participant coordination is a must. • The 7th Asia Telemedicine Symposium, 2013 9

Manish Dutta, Institute of Liver and Biliary Sciences Thank You The 7th Asia Telemedicine Symposium, 2013 10