Abstract
.A coaxial projective imaging (CPI) module acquires surgical scene images from the local site of surgery, transfers them wirelessly to the remote site, and projects instructive annotations to the surgical field. At the remote site, the surgical scene images are displayed, and the instructive annotations from a surgical specialist are wirelessly transferred back to the local site in order to guide the surgical intervention by a less experienced surgeon. The CPI module achieves seamless imaging of the surgical field and accurate projection of the instructive annotations, by a coaxial optical path design that couples the imaging arm with the projection arm and by a color correction algorithm that recovers the true color of the surgical scene. Our benchtop study of tele-guided intervention verifies that the proposed system has a positional accuracy of better than 1 mm at a working distance ranging from 300 to 500 mm. Our in vivo study of cricothyrotomy in a rabbit model proves the concept of tele-mentored surgical navigation. This is the first report of tele-guided surgery based on CPI. The proposed technique can be potentially used for surgical training and for telementored surgery in resource-limited settings.
Highlights
Despite recent advances in surgical science, further dissemination of modern surgical techniques to impact human health and welfare is hindered by healthcare disparities, especially among socially disadvantaged populations who may have only limited resources.[1]
The key component of the proposed projective telementoring and surgical navigation system is a CPI-1 coaxial projective imaging module, which is capable of acquiring the surgical scene images and displaying the annotations simultaneously at the site of surgery
To avoid interference of the projected annotations with the surgical scene images acquired by the charge-coupled diode (CCD) camera, a 530-nm band-pass filter and a 532-nm notch filter are placed on the projector arm and the camera arm of the coaxial optical path, respectively
Summary
Despite recent advances in surgical science, further dissemination of modern surgical techniques to impact human health and welfare is hindered by healthcare disparities, especially among socially disadvantaged populations who may have only limited resources.[1]. The emerging field of telemedicine has the potential to overcome such disparities by bringing personalized healthcare and surgical expertise closer to patients in underdeveloped regions or isolated settings.[2,3,4] If emergency care is needed in such a setting, a telemedicine tool may help a medical specialist guide surgical intervention when the personnel on site have little or no relevant experience.[5,6] In addition, a telemedicine tool may help in an educational setting to allow an experienced surgeon to teach complicated surgical procedures in an interactive way that may be superior to conventional educational tools such as video conferencing.[7,8] By using a telemedicine tool, a less experienced surgeon at the site of surgery is able to share the same sight of view with a surgical specialist at the remote site, enabling interactive knowledge transfer, seamless decision making, and instructed intervention without a distance barrier.[9,10]
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