Virtual interactive presence for real-time, long-distance surgical collaboration during complex microsurgical procedures: Technical note

Mahesh B. Shenai, R. Shane Tubbs, Barton L. Guthrie, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Object. The shortage of surgeons compels the development of novel technologies that geographically extend the capabilities of individual surgeons and enhance surgical skills. The authors have developed "Virtual Interactive Presence" (VIP), a platform that allows remote participants to simultaneously view each other's visual field, creating a shared field of view for real-time surgical telecollaboration. Methods. The authors demonstrate the capability of VIP to facilitate long-distance telecollaboration during cadaveric dissection. Virtual Interactive Presence consists of local and remote workstations with integrated video capture devices and video displays. Each workstation mutually connects via commercial teleconferencing devices, allowing worldwide point-to-point communication. Software composites the local and remote video feeds, displaying a hybrid perspective to each participant. For demonstration, local and remote VIP stations were situated in Indianapolis, Indiana, and Birmingham, Alabama, respectively. A suboccipital craniotomy and microsurgical dissection of the pineal region was performed in a cadaveric specimen using VIP. Task and system performance were subjectively evaluated, while additional video analysis was used for objective assessment of delay and resolution. Results. Participants at both stations were able to visually and verbally interact while identifying anatomical structures, guiding surgical maneuvers, and discussing overall surgical strategy. Video analysis of 3 separate video clips yielded a mean compositing delay of 760 ± 606 msec (when compared with the audio signal). Image resolution was adequate to visualize complex intracranial anatomy and provide interactive guidance. Conclusions. Virtual Interactive Presence is a feasible paradigm for real-time, long-distance surgical telecollaboration. Delay, resolution, scaling, and registration are parameters that require further optimization, but are within the realm of current technology. The paradigm potentially enables remotely located experts to mentor less experienced personnel located at the surgical site with applications in surgical training programs, remote proctoring for proficiency, and expert support for rural settings and across different counties.

Original languageEnglish
Pages (from-to)277-284
Number of pages8
JournalJournal of Neurosurgery
Volume121
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Dissection
Technology
Equipment and Supplies
Mentors
Craniotomy
Task Performance and Analysis
Visual Fields
Surgical Instruments
Anatomy
Software
Communication
Education
Surgeons

Keywords

  • Collaboration
  • Microsurgical procedure
  • Telecommunication
  • Virtual interactive presence

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

Virtual interactive presence for real-time, long-distance surgical collaboration during complex microsurgical procedures : Technical note. / Shenai, Mahesh B.; Tubbs, R. Shane; Guthrie, Barton L.; Cohen-Gadol, Aaron.

In: Journal of Neurosurgery, Vol. 121, No. 2, 2014, p. 277-284.

Research output: Contribution to journalArticle

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