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Wagner, A; Undt, G; Schicho, K; Wanschitz, F; Watzinger, F; Murakami, K; Czerny, C; Ewers, R.
Interactive stereotaxic teleassistance of remote experts during arthroscopic procedures.
Arthroscopy. 2002; 18(9):1034-1039 Doi: 10.1053/jars.2002.36464 (- Case Report)
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Co-authors Med Uni Graz
Schicho Kurt
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Abstract:
This article describes the technical setup for stereotaxic telesurgical assistance for arthroscopic procedures. It also outlines the current state, limitations, and feasibility of this technical development. Teleassistance or teleconsultation implemented in endoscopic or arthroscopic procedures have not yet been reported. In this study, 7 computer-assisted arthroscopies of the temporomandibular joint were supported by extramural experts via interactive stereotaxic teleconsultation from distant locations. The external experts were supplied with close to real-time video, audio, and stereotaxic navigation data directly from the operation site. This setup allows the surgeons and external experts to interactively determine portals, target structures, and instrument positions relative to the patient's anatomy and to discuss any step of the procedures. Optoelectronic tracking interfaced to computer- based navigation technology allowed precise positioning of instruments for single or multiple temporomandibular joint punctures. The average error of digitizing probe measurements was 1.3 mm (range, 0.0 to 2.5 mm) and the average standard deviation was 0.7 mm (range, 0.4 to 0.9 mm). Evaluation of the reliability and accuracy of this technique suggests that it is sufficient for controlled navigation, even inside the small temporomandibular joint, a fact that encourages further applications for arthroscopy in general. The minimum requirement for high-quality video transmission for teleassisted procedures are integrated services digital network (ISDN) connections. Conventional ISDN-based videoconferencing can be combined with computer-aided intraoperative navigation. Transmission control protocol/internet protocol (TCP/IP)-based stereotaxic teleassistance data transmission via ATM or satellite seem to be promising techniques to considerably improve the field of arthroscopy.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Analog-Digital Conversion -
Arthroscopy - methods
Computer Systems -
Female -
Humans -
Internet -
Laser Therapy - instrumentation Laser Therapy - methods
Satellite Communications -
Software -
Stereotaxic Techniques -
Telemedicine -
Telephone -
Temporomandibular Joint - surgery
Temporomandibular Joint Disorders - surgery
Tissue Adhesions - surgery
Video-Assisted Surgery -

Find related publications in this database (Keywords)
arthroscopy
interactive teleconsultation
stereotaxic teleassistance
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