Background: Tele-mentoring facilitates the transfer of surgical knowledge. The objective of this work is to develop a tele-mentoring framework that enables a specialist surgeon to mentor an operating surgeon by transferring information in a form of surgical instruments' motion required during a minimally invasive surgery. Method:A tele-mentoring framework is developed to transfer video stream of the surgical field, poses of the scope and port placement from the operating room to a remote location. From the remote location, the motion of virtual surgical instruments augmented onto the surgical field is sent to the operating room. Results:The proposed framework is suitable to be integrated with laparoscopic as well as robotic surgeries. It takes on average 1.56 s to send information from the operating room to the remote location and 0.089 s for vice versa over a local area network. Conclusions:The work demonstrates a tele-mentoring framework that enables a specialist surgeon to mentor an operating surgeon during a minimally invasive surgery. K E Y W O R D Saugmented reality, minimally invasive surgeries, tele-mentoring, telemedicine | INTRODUCTIONAs surgery has evolved from open to minimally invasive, the framework of tele-mentoring technologies has largely remained the same. [1][2][3] It still involves basic exchange of audio and annotated video messages, and lacks augmentation of information pertaining to surgical tool motion and tool-tissue interaction. 4,5 In an operating room setup of minimally invasive surgery (MIS), the surgeon operates on a patient using surgical instruments inserted through small incisions. These surgical instruments can either be manually operated (such as laparoscopic instruments) or robotically actuated.Along with instruments, a scope (camera) is also inserted inside the patient's body to visualise the interaction of surgical instruments' tooltips with the tissue. In the case of manual MIS, the surgeon This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Background Tele-mentoring during surgery facilitates the transfer of surgical knowledge from a mentor (specialist surgeon) to a mentee (operating surgeon). The aim of this work is to develop a tele-mentoring system tailored for minimally invasive surgery (MIS) where the mentor can remotely demonstrate to the mentee the required motion of the surgical instruments. Methods A remote tele-mentoring system is implemented that generates visual cues in the form of virtual surgical instrument motion overlaid onto the live view of the operative field. The technical performance of the system is evaluated in a simulated environment, where the operating room and the central location of the mentor were physically located in different countries and connected over the internet. In addition, a user study was performed to assess the system as a mentoring tool. Results On average, it took 260 ms to send a view of the operative field of 1920 × 1080 resolution from the operating room to the central location of the mentor and an average of 132 ms to receive the motion of virtual surgical instruments from the central location to the operating room. The user study showed that it is feasible for the mentor to demonstrate and for the mentee to understand and replicate the motion of surgical instruments. Conclusion The work demonstrates the feasibility of transferring information over the internet from a mentor to a mentee in the form of virtual surgical instruments. Their motion is overlaid onto the live view of the operative field enabling real-time interactions between both the surgeons.
Background: Recent tele-mentoring technologies for minimally invasive surgery (MIS) augments the operative field with movements of virtual surgical instruments as visual cues. The objective of this work is to assess different user-interfaces that effectively transfer mentor's hand gestures to the movements of virtual surgical instruments.Methods: A user study was conducted to assess three different user-interface devices (Oculus-Rift, SpaceMouse, Touch Haptic device) under various scenarios. The devices were integrated with a MIS tele-mentoring framework for control of both manual and robotic virtual surgical instruments. Results:The user study revealed that Oculus Rift is preferred during robotic scenarios, whereas the touch haptic device is more suitable during manual scenarios for tele-mentoring. Conclusion:A user-interface device in the form of a stylus controlled by fingers for pointing in 3D space is more suitable for manual MIS, whereas a user-interface that can be moved and oriented easily in 3D space by wrist motion is more suitable for robotic MIS.
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