Real-Time Streaming of Surgery Performance and Intraoperative Imaging Data in the Hybrid Operating Room: Development and Usability Study.

Chun-Cheng Lin,Ming-Chau Chang,Chao-Ching Chiang,Oscar Kuang-Sheng Lee,Yu-Pin Chen

doi:10.2196/18094

Chun-Cheng Lin, Ming-Chau Chang + Show 3 more

Open Access

https://doi.org/10.2196/18094

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Abstract

BackgroundThe trend of quick evolution and increased digital data in today’s operating rooms (ORs) has led to the construction of hybrid ORs. There is often a main control room with monitors for integrating intraoperative data from multiple devices in the hybrid OR. However, there is no adequate solution for communicating the data with people outside the OR.ObjectiveThe objective of this study was to design an intelligent operating room (iOR) system, augmented onto the existing information technology (IT) infrastructure of hybrid ORs, to stream surgery performance and intraoperative imaging data.MethodsIn this study, an all-in-one device with synergetic encoder and decoder was used. The device was able to stream multiple sources to one display. The lossless video and images from specific surgical workflows were streamed outside the hybrid OR through network protocols and were further managed by a streaming server and wireless control system. The steps of this study included the following: (1) defining the requirements and feasibility of an iOR system in the hybrid OR, (2) connecting multiple sources, (3) setting up equipment across the hybrid OR and a conference room, (4) designing a video management system, and (5) real-time streaming under specific surgical workflows.ResultsThe wired streamed video was shown simultaneously on the display in the hybrid OR and the display in the conference room with near-zero latency. Additionally, an interactive video between the hybrid OR and the conference room was achieved through the bidirectional wireless control system. The functions of recording, archiving, and playback were successfully provided by the streaming server. The readily available hardware components and open-access programming reduced the cost required to construct this streaming system.ConclusionsThis flexible and cost-effective iOR system not only provided educational benefits, but also contributed to surgical telementoring.

Highlights

We proposed the resolution of streaming all data out of the hybrid operating rooms (ORs) by using the principle of “one NDcoder connecting one data source”
When searching for a commercially available streaming system designed for the hybrid OR, we found that the price of one medical grade monitor was higher than the cost of all the equipment used in the intelligent operating room (iOR) system
This could be due to the costs associated with importing the products of an international brand

Summary

Introduction

The steps of this study included the following: (1) defining the requirements and feasibility of an iOR system in the hybrid OR, (2) connecting multiple sources, (3) setting up equipment across the hybrid OR and a conference room, (4) designing a video management system, and (5) real-time streaming under specific surgical workflows. The hybrid operating room (OR) is defined as being equipped with advanced medical devices such as fixed C-arm fluoroscopy, cameras, a computed tomography (CT) scanner, or a magnetic resonance imaging (MRI) scanner [1]. In addition to these imaging and video devices, there is often a main control room with monitors for integrating intraoperative data. Other drawbacks to OR setups of this kind include a lack of streaming outside the OR, the need for high-cost customized software for video management, and difficulty in integration with new devices of different brands, such as an incompatibility between imaging and surgical navigation systems

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