Tele-Operated Echography and Remote Guidance for Performing Tele-Echography on Geographically Isolated Patients

Abstract

Objective: To evaluate the performance of three tele-echography systems for routine use in isolated medical centers. Methods: Three systems were used for deep (abdomen, pelvis, fetal) and superficial (muscle, thyroid, carotid artery) examinations: (a) a robotic arm (RA) holding an echographic probe; (b) an echograph with a motorized probe (MP); and (c) remote guidance (RG) where the patient site operator performed the examination assisted by an expert via videoconference. All systems were tested in the same medical center located 60 km away from the university hospital. Results: A total of 340 remote echography examinations were performed (41% RA and MP, 59% RG). MP and RA allowed full control of the probe orientation by the expert, and provided diagnoses in 97% of cases. The use of RG was sufficient for superficial vessel examinations and provided diagnoses in 98% of cases but was not suited for deep or superficial organs. Assessment of superficial organs was best accomplished using the MP. Discussion: Both teleoperated systems provided control of the probe orientation by the expert necessary for obtaining appropriate views of deep organs but the MP was much more ergonomic and easier to use than the RA. RG was appropriate for superficial vessels while the MP was better for superficial volumic organs.

Telerobotic Sonography for Remote Diagnostic Imaging

“…More recently, the size of the probe manipulator was reduced by adding small internal motors to a commercial ultrasound probe 23 . The motorized probe allows sonographers to remotely tilt and rotate the probe, although other movements, including translation, must be made by an assistant based on guidance provided by the sonographer.…”

“…The motorized probe allows sonographers to remotely tilt and rotate the probe, although other movements, including translation, must be made by an assistant based on guidance provided by the sonographer. This design does not include a frame, which is held by the patient site assistant; rather, the patient site assistant directly holds the ultrasound probe 23 . A cohort study comparing motorized probes to a spherical wristlike robotic arm found, on the basis of anecdotal reports, that general practitioners who performed the examinations at the patient site under the guidance of a sonographer thought that the motorized probe system was more ergonomic and easier to use 23 .…”

“…This design does not include a frame, which is held by the patient site assistant; rather, the patient site assistant directly holds the ultrasound probe 23 . A cohort study comparing motorized probes to a spherical wristlike robotic arm found, on the basis of anecdotal reports, that general practitioners who performed the examinations at the patient site under the guidance of a sonographer thought that the motorized probe system was more ergonomic and easier to use 23 . However, the study did not directly compare the diagnostic performance of each method of scanning in a case‐crossover design.…”

“…For certain examinations, however, remote guidance without telerobotic technology may be preferable. Arbeille et al 23 found that remote guidance using an ultrasound system in which experts could remotely control ultrasound settings while a general practitioner performed the examination was preferable to using a robotic arm or motorized probes for interrogation of superficial vessels. The examination type and skills of the assistant or clinician at the patient site will be key considerations in determining an optimal solution for remote sonography.…”

The place of health innovation in space to improve the lives of earthlings

“…The only mandatory things are to make sure that the subject, the patient and al tools are correctly restraint. Of course all activities take more time and need to be train [41][42][43][44][45][46].…”