RURAL TELESURGERY NETWORK CHARACTERIZATION FOR FUTURE REMOTE CARDIAC CATHETER ABLATION

Abstract

BackgroundTelesurgery involves a remote surgeon operating on a patient over distance using the internet to control a surgical robot. Telesurgery could allow rural patients more equitable access to lifesaving specialty procedures such as cardiac catheter ablation. Advances in telehealth adoption and surgical robotics are lowering the conceptual and technical hurdles for this future method of healthcare delivery. Despite this, important questions remain regarding the safe implementation of telesurgery in rural community hospitals. In particular, it is critical to understand the spatial, temporal, and content dependent variations in network performance between urban and rural hospitals. Presently, no one has meaningfully characterized internet performance for telesurgical procedures in rural areas.ObjectiveThe purpose of this research is to measure real-world internet performance and characterize the risk and severity of network disruptions during simulated telesurgeries between urban and rural hospitals over a long duration.MethodsWe developed a python application to generate and receive simulated telesurgery data between an urban center and small servers that are physically located in rural hospital operating rooms (Figure 1). Simulated telesurgeries were performed daily and nightly for 90min at approximately 2 packets per second.ResultsThe packet latency distribution for 108 simulated surgeries (54 daytime; 54 nighttime) is shown in Figure 2. We found that 99.99% of the packets had a network latency of less than 250ms and only 10% of operations had at one or more packets delayed by 250ms or more.ConclusionFigure 2. Network latency vs. percent of packets for all simulated telesurgeriesView Large Image Figure ViewerDownload Hi-res image Download (PPT) BackgroundTelesurgery involves a remote surgeon operating on a patient over distance using the internet to control a surgical robot. Telesurgery could allow rural patients more equitable access to lifesaving specialty procedures such as cardiac catheter ablation. Advances in telehealth adoption and surgical robotics are lowering the conceptual and technical hurdles for this future method of healthcare delivery. Despite this, important questions remain regarding the safe implementation of telesurgery in rural community hospitals. In particular, it is critical to understand the spatial, temporal, and content dependent variations in network performance between urban and rural hospitals. Presently, no one has meaningfully characterized internet performance for telesurgical procedures in rural areas. Telesurgery involves a remote surgeon operating on a patient over distance using the internet to control a surgical robot. Telesurgery could allow rural patients more equitable access to lifesaving specialty procedures such as cardiac catheter ablation. Advances in telehealth adoption and surgical robotics are lowering the conceptual and technical hurdles for this future method of healthcare delivery. Despite this, important questions remain regarding the safe implementation of telesurgery in rural community hospitals. In particular, it is critical to understand the spatial, temporal, and content dependent variations in network performance between urban and rural hospitals. Presently, no one has meaningfully characterized internet performance for telesurgical procedures in rural areas. ObjectiveThe purpose of this research is to measure real-world internet performance and characterize the risk and severity of network disruptions during simulated telesurgeries between urban and rural hospitals over a long duration. The purpose of this research is to measure real-world internet performance and characterize the risk and severity of network disruptions during simulated telesurgeries between urban and rural hospitals over a long duration. MethodsWe developed a python application to generate and receive simulated telesurgery data between an urban center and small servers that are physically located in rural hospital operating rooms (Figure 1). Simulated telesurgeries were performed daily and nightly for 90min at approximately 2 packets per second. We developed a python application to generate and receive simulated telesurgery data between an urban center and small servers that are physically located in rural hospital operating rooms (Figure 1). Simulated telesurgeries were performed daily and nightly for 90min at approximately 2 packets per second. ResultsThe packet latency distribution for 108 simulated surgeries (54 daytime; 54 nighttime) is shown in Figure 2. We found that 99.99% of the packets had a network latency of less than 250ms and only 10% of operations had at one or more packets delayed by 250ms or more. The packet latency distribution for 108 simulated surgeries (54 daytime; 54 nighttime) is shown in Figure 2. We found that 99.99% of the packets had a network latency of less than 250ms and only 10% of operations had at one or more packets delayed by 250ms or more. Conclusion