Virtual Interactive Presence in Global Surgical Education: International Collaboration Through Augmented Reality
Virtual Interactive Presence in Global Surgical Education: International Collaboration Through Augmented Reality
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DOI：
10.1016/j.wneu.2015.08.053
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发表时间：
2016-02-01
影响因子：
2
通讯作者：
Johnston, James M.
中科院分区：
文献类型：
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作者：
Davis, Matthew Christopher;Can, Dang D.;Johnston, James M.
背景技术背景：允许远程经验丰富的外科医生为当地外科医生提供实时指导的技术在全球医疗中心的培训和能力建设方面具有巨大的潜力。虚拟交互式存在和增强现实（VIPAR）是一种基于iPad的工具，允许外科医生在任何无线互联网连接可用的地方提供远距离虚拟协助。本地和远程外科医生在每个站点查看视频馈送的合成图像，从而允许在真实的time.METHODS术中远程会诊：在越南的胡志明市和亚拉巴马的伯明翰建立本地和远程站点，作为正在进行的神经外科协作的一部分。内窥镜下第三脑室造口术与脉络丛凝固与VIPAR被用于主观和客观评价系统performance.RESULTS：VIPAR允许两名外科医生从事复杂的视觉和语言交流过程中。对5个视频剪辑的分析显示，相对于音频信号，视频延迟为237毫秒（范围，93-391毫秒）。出色的图像分辨率使远程神经外科医生能够可视化所有关键解剖结构。远程神经外科医生可以对结构做手势，而不同站点之间的准确度没有可检测的差异，从而实现亚毫米级的精度。在越南和美国之间，使用VIPAR进行了15例内镜下第三脑室造瘘术和脉络丛凝固手术，无明显并发症。80%的这些患者仍然shunt-free.CONCLUSION：不断发展的技术，允许远程，术中指导，知识转移，高效的国际神经外科教育具有很大的潜力。VIPAR是一个廉价的，可扩展的平台，以增加全球神经外科能力的一个例子。正在努力建立一个使用VIPAR进行合作的越南神经外科医生网络。
BACKGROUND: Technology allowing a remote, experienced surgeon to provide real-time guidance to local surgeons has great potential for training and capacity building in medical centers worldwide. Virtual interactive presence and augmented reality (VIPAR), an iPad-based tool, allows surgeons to provide long-distance, virtual assistance wherever a wireless internet connection is available. Local and remote surgeons view a composite image of video feeds at each station, allowing for intraoperative telecollaboration in real time.METHODS: Local and remote stations were established in Ho Chi Minh City, Vietnam, and Birmingham, Alabama, as part of ongoing neurosurgical collaboration. Endoscopic third ventriculostomy with choroid plexus coagulation with VIPAR was used for subjective and objective evaluation of system performance.RESULTS: VIPAR allowed both surgeons to engage in complex visual and verbal communication during the procedure. Analysis of 5 video clips revealed video delay of 237 milliseconds (range, 93-391 milliseconds) relative to the audio signal. Excellent image resolution allowed the remote neurosurgeon to visualize all critical anatomy. The remote neurosurgeon could gesture to structures with no detectable difference in accuracy between stations, allowing for submillimeter precision. Fifteen endoscopic third ventriculostomy with choroid plexus coagulation procedures have been performed with the use of VIPAR between Vietnam and the United States, with no significant complications. 80% of these patients remain shunt-free.CONCLUSION: Evolving technologies that allow longdistance, intraoperative guidance, and knowledge transfer hold great potential for highly efficient international neurosurgical education. VIPAR is one example of an inexpensive, scalable platform for increasing global neurosurgical capacity. Efforts to create a network of Vietnamese neurosurgeons who use VIPAR for collaboration are underway.