Robotic long-distance telementoring in neurosurgery
Robotic long-distance telementoring in neurosurgery
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DOI：
10.1227/01.neu.0000153928.51881.27
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发表时间：
2005-03-01
期刊：
影响因子：
4.8
通讯作者：
Walling, S
中科院分区：
文献类型：
--
作者：
Mendez, I;Hill, R;Walling, S
目的：为了测试在神经外科中通过在真实的时间向在远程位置执行外科手术的另一神经外科医生提供亚专业的专业知识来进行远程监护的可行性。圣巴巴拉，CA），能够控制机器人臂的运动，处理双向视频，音频通信以及从远程手术室传输神经导航数据，用于远程监护程序。四条综合业务数字网络线路，总传输速度为每秒512兆字节，为一个大型学术中心和一个大型研究中心提供电信服务。（哈利法克斯，新斯科舍省）和一个社区中心（Saint John，新玩法）位于400 km之外。远程远程监护用于3例脑肿瘤开颅术、1例动静脉畸形开颅术、1例颈动脉内膜切除术，和腰椎椎板切除术手术过程中无手术并发症，所有患者均无不良结局。在远程位置的神经外科医生认为，从导师的输入是有用的，在所有的情况下，是至关重要的内侧颞叶胶质瘤和切除枕部动静脉畸形。结论：我们的初步经验与长距离机器人辅助远程6例表明，远程是可行的，可靠的，安全的。虽然仍处于起步阶段，远程监护有可能改善外科护理，加强神经外科培训，并对世界各地的神经外科服务的提供产生重大影响。
OBJECTIVE: To test the feasibility of long-distance telementoring in neurosurgery by providing subspecialized expertise in real time to another neurosurgeon performing a surgical procedure in a remote location.METHODS: A robotic telecollaboration system (Socrates; Computer Motion, Inc., Santa Barbara, CA) capable of controlling the movements of a robotic arm, of handling two-way video, and of audio communication as well as transmission of neuronavigational data from the remote operating room was used for the telementoring procedures. Four integrated services digital network lines with a total speed of transmission of 512 kilobytes per second provided telecommunications between a large academic center (Halifax, Nova Scotia) and a community-based center (Saint John, New Brunswick) located 400 km away.RESULTS: Long-distance telementoring was used in three craniotornies for brain tumors, a craniotomy for an arteriovenous malformation, a carotid endarterectomy, and a lumbar laminectomy. There were no surgical complications during the procedures, and all patients had uneventful outcomes. The neurosurgeons in the remote location believed that the input from the mentors was useful in all of the cases and was crucial in the removal of a mesial temporal lobe glioma and resection of an occipital arteriovenous malformation.CONCLUSION: Our initial experience with long-distance robotic-assisted telementoring in six cases indicates that telementoring is feasible, reliable, and safe. Although still in its infancy, telementoring has the potential to improve surgical care, to enhance neurosurgical training, and to have a major impact on the delivery of neurosurgical services throughout the world.