Tele-assessment of bandwidth limitation for remote robotics surgery

Abstract

Purpose We investigated the communication bandwidth (CB) limitation for remote robotics surgery (RRS) using hinotori™ (Medicaroid, Kobe, Japan). Methods The operating rooms of the Hokkaido University Hospital and Kyushu University Hospital were connected using the Science Information NETwork (SINET). The minimum required CB for the RRS was verified by decreasing the CB from 500 to 100 Mbps. Ten surgeons were tested on a task (intracorporeal suturing) at different levels of video compression (VC) (VC1: 120 Mbps, VC2: 40 Mbps, VC3: 20 Mbps) with the minimum required CB, and assessed based on the task completion time, Global Evaluative Assessment of Robotic Skills (GEARS), and System and Piper Fatigue Scale-12 (PFS-12). Results Packet loss was observed at 3–7% and image degradation was observed at 145 Mbps CB. The task performance with VC1 was significantly worse than that with VC2 and VC3 according to the task completion time (VC1 vs VC2, P = 0.032; VC1 vs. VC3, P = 0.032), GEARS (VC1 vs VC2; P = 0.029, VC1 vs VC3; P = 0.031), and PFS-12 (VC1 vs. VC2; P = 0.032, VC1 vs. VC3; P = 0.032) with 145 Mbps. Conclusion Our findings provide evidence that RRS using hinotori™ requires a CB ≥ 150 Mbps. We also found that when there is insufficient CB, RRS can be continued by compressing the image.

Verification of delay time and image compression thresholds for telesurgery

“…(Figure 5). Ebihara et al reported that telerobotic surgery can be performed safely with a communication bandwidth of 150 Mbps or higher, and even when the communication bandwidth is insufficient, image degradation can be avoided by considering the image compression ratio 13 . In addition, Edward et al reported that telesurgery can be performed at bit rates of 8–20 Mbps 14 .…”

“…Ebihara et al reported that telerobotic surgery can be performed safely with a communication bandwidth of 150 Mbps or higher, and even when the communication bandwidth is insufficient, image degradation can be avoided by considering the image compression ratio. 13 In addition, Edward et al reported that telesurgery can be performed at bit rates of 8-20 Mbps. 14 Therefore, there is a possibility that remote robotic surgery can be performed even when the communication bandwidth is not sufficient, as in the case of mobile communication.…”

Reappraisal of telesurgery in the era of high‐speed, high‐bandwidth, secure communications: Evaluation of surgical performance in local and remote environments

“…The RTT time was a median of 4 [2][3][4][5][6][7][8][9][10][11][12] msec. The delay between encoder and decoder was 25 msec of the encoder-decoder processing time.…”

“…We conducted a demonstration of telerobotic surgery using a commercial line as a preliminary study in February 2021, and reported that it was possible to build a communication environment conducive to remote surgery 7 . In August 2021, hinotori™️ (Medicaroid Corporation) was successfully operated remotely over a distance of 2000 km using a Science Information NETwork (SINET) 8 . However, since the communication delay and the video transmission information delay vary depending on the communication environment to be constructed and the robot to be used, it is necessary to verify communication environments and the robots involved in various combinations.…”

“… 7 In August 2021, hinotori™️ (Medicaroid Corporation) was successfully operated remotely over a distance of 2000 km using a Science Information NETwork (SINET). 8 However, since the communication delay and the video transmission information delay vary depending on the communication environment to be constructed and the robot to be used, it is necessary to verify communication environments and the robots involved in various combinations.…”