The actual problems with live demo surgeries Specific way of teaching and exchanging of the experiences in the Medicine Jiri Navratil 1 , Sven Ubik 1 ,Pavel Peciva 2 1 CESNET a.l.e. Zikova 4, Prague, 16000 Czech Republic 2 Krajska Zdravotní a.s., MNUL, Socialni pece 3316, Usti nad Labem, 40011 Czech Republ The 6 th Asia Telemedicine Symposium December 14 th , 2012 Fukuoka, Japan CESNET is research organization sponsored by Ministry of Education CR and academic community • • 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 creates an ideal environment for medical collaboration Network connects all Medical Faculties and all large hospitals University hospitals (11) Military hospitals (2) MNUL Research hospitals (16) via NIX to other hospitals in the regions To other Havl.Brod Nové M ě sto na M. hospitals Via EXCHANGE POINT Písek Hodonín
Forms of supports to medical communities • 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) 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
LiveSurgery 1) H323 videoconference units (0,5 - 6 Mbps with compression) (codec – high compression Low quality of coloures and grey scale, high latency) 2) DVTS (35 Mbps) 3) MVTP-4K (1,5 – 10 Gbps) Software, no compression, no internal latency Quality defined by the camera FullHD quality, no compression, No internal latency, up to 8 channels, 3D DVTS - Plus since 2010 (CERNET application) Multipoint VC, princip Client-Server, Internet connection 35 Mbps 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 Voice1 Voice 2 (microphone.) Video Video (fro m robot) v1 v3 Video v2 ENC3 ENC1 Video ENC2 v4 IP ENC4 IP IP IP Hospital N e t w o r k Seminar room mcast Projector 2 Screen 1 IP IP IP IP v v VLC receiver: v1 | v2 |v3| v4 1 2 According to the teacher VLC receiver: v1 | v2 |v3| v4 v v 4 3 According to the teacher Management machine with all video signals on 4 windows s v1,v2,v3,v4 (for teacher decisions) for Questions
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 3D Video unit HD 3D camera
3D video - General scenario using MVTP-4K Robot da Vinci Modular Video Transport Platform - codec http://www.ces.net/project/qosip/hw/mvtp-4k.pdf MVTP-4k NETWORK 2 HD videosignals 10Gbps Left a Right eye Video from Operation room MVTP-4k H323 2 HD videosignals Video conference Left a Right eye F10 AS3D Stereo projector F10AS3D ZD101 DLP http://www.ces.net/project/qosip/hw/mvtp-4K-v2.pdf 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 IN: 8x HD-SDI OUT: 8x HD-SDI Network – 10 Gigabit Ethernet
3D screen videoconference Telebridge Ústi nad Labem (CR) – Banská Bystrica (SK) 3D screen videoconference CESNET – SANET Collaboration: daVinchi operation in MNUL to Banska Bystrica
3D projectors Cheap passive glasses Problem: expensive projectors Advantage: quantity, large halls
DepthQ PM unit for conversion from Active to Passive 3D glasses Stereo projector F10AS3D MVTP-4k
Cheap 3D screens (LG,SAMSUNG,Panasonic) Cheap passive glasses Limitations: for individuals or small lab set 3D screen A B C ZOF 2012 Zlin’s Eyes Festival Projection to 3 screens: A,B,C
This is 3D Cinema projector
left eye view right eye view 3D video in monoscopic view (without 3D glasses, all is doubled, blurred)
Streamed into Internet XIX congress of GPSSLS at Bratislava (SK) 4 parallel surgeries
DepthQ PM unit for conversion from Active to Passive 3D glasses Stereo projector F10AS3D MVTP-4k 2012 3D screen from robot daVinci
3D screen Live surgery Moderator Internet stream
Interesting events in 2012
After 2 years of experiments 2D/3D dilemma 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 ? Thank you for attention
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