Use of mobile low-bandwith telemedical techniques for extreme telemedicine applications

Rosser, James C.; Bell, Robert L.; Harnett, Brett; Rodas, Edgar B.; Murayama, Michinori; Merrell, Ronald C.

doi:10.1016/s1072-7515(99)00185-4

Cited by 74 publications

(67 citation statements)

References 15 publications

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“…1 Similar work was also conducted using plain old telephone system (POTS) from the jungles of Ecuador. 2 In both cases, low bandwidth proved to be very useful for telemedicine applications. Internet-2 has been shown to provide high-resolution images, 3 but Internet-2 is simply another broadband technology, which will not be broadly available in the foreseeable future in most regions of the world.…”

Section: Discussionmentioning

confidence: 99%

Real-Time Internet Connections: Implications for Surgical Decision Making in Laparoscopy

Broderick¹,

Harnett²,

Doarn³

et al. 2001

Annals of Surgery

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ObjectiveTo determine whether a low-bandwidth Internet connection can provide adequate image quality to support remote realtime surgical consultation. Summary Background DataTelemedicine has been used to support care at a distance through the use of expensive equipment and broadband communication links. In the past, the operating room has been an isolated environment that has been relatively inaccessible for real-time consultation. Recent technological advances have permitted videoconferencing over low-bandwidth, inexpensive Internet connections. If these connections are shown to provide adequate video quality for surgical applications, low-bandwidth telemedicine will open the operating room environment to remote real-time surgical consultation. MethodsSurgeons performing a laparoscopic cholecystectomy in Ecuador or the Dominican Republic shared real-time laparoscopic images with a panel of surgeons at the parent university through a dial-up Internet account. The connection permitted video and audio teleconferencing to support realtime consultation as well as the transmission of real-time images and store-and-forward images for observation by the consultant panel. A total of six live consultations were analyzed. In addition, paired local and remote images were "grabbed" from the video feed during these laparoscopic cholecystectomies. Nine of these paired images were then placed into a Web-based tool designed to evaluate the effect of transmission on image quality. ResultsThe authors showed for the first time the ability to identify critical anatomic structures in laparoscopy over a low-bandwidth connection via the Internet. The consultant panel of surgeons correctly remotely identified biliary and arterial anatomy during six laparoscopic cholecystectomies. Within the Web-based questionnaire, 15 surgeons could not blindly distinguish the quality of local and remote laparoscopic images. ConclusionsLow-bandwidth, Internet-based telemedicine is inexpensive, effective, and almost ubiquitous. Use of these inexpensive, portable technologies will allow sharing of surgical procedures and decisions regardless of location. Internet telemedicine consistently supported real-time intraoperative consultation in laparoscopic surgery. The implications are broad with respect to quality improvement and diffusion of knowledge as well as for basic consultation.Telemedicine has been used to support care at a distance through the use of expensive equipment and broadband communication links. In the past, the operating room has been an isolated environment that has been relatively inaccessible for real-time consultation. Recent technological advances have permitted videoconferencing over low-bandwidth, inexpensive Internet connections. If these connections are shown to provide adequate video quality for surgical applications, low-bandwidth telemedicine will revolutionize surgical practice by enabling remote real-time surgical consultation.Many of the regions around the world that have the most need for advanced surgical mentoring can le...

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Section: Discussionmentioning

confidence: 99%

Real-Time Internet Connections: Implications for Surgical Decision Making in Laparoscopy

Broderick¹,

Harnett²,

Doarn³

et al. 2001

Annals of Surgery

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“…Not only were the clinicians in Tanzania able to seek expert advice, they were also able to provide assistance to Swiss clinicians for tropical diseases in returning travellers. Surgical telemonitoring has been used in Ecuador to guide inexperienced surgeons through advanced procedures in remote areas within a mobile theatre (Rosser Jr et al, 1999). The original initiative did not use telemedicine, meaning that surgeons needed to travel long distances across difficult terrain to reach the patients in order to perform preoperative and postoperative evaluation.…”

Section: How Else Has Telemedicine Been Used Around the World?mentioning

confidence: 99%

eHealth Projects of the Microgravity Centre

Russomano¹,

Cardoso²,

Jones³

et al. 2011

Biomedical Engineering, Trends, Research and Technologies

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“…For example, an integrated services digital network (ISDN) connection, with a bandwidth of 384 kB per second (six lines) is required to give sufficient picture quality for precise elucidation by the adviser (although clinical work has been carried out using bandwidths as low as 128 Kb per second [Rosser JC, ,1999]. …”

Section: Technical Considerationsmentioning

confidence: 99%