26 settembre

2018

SEF Project in Oral and Maxillofacial Surgery (Smart videosurgery, Easy teleteaching and Fast teleassistance)

Alessandro Tel1, Federico Bortuzzo2, Fabio Costa1, Salvatore Sembronio1, Vittorio Bresadola3, Massimo Robiony1

1 Maxillofacial Surgery Department, University of Udine, Italy2 CEO, BlueDigit Informatics, italy3 General Surgery Department, University of Udine, Italy

Alessandro Tel, MD

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Obiettiviedestinataridellavoro

LaplurivalenzadelprogettoSEFsiprestaasoddisfareleesigenzedimoltepliciutenti:

- Imediciinformazionepossonoavereunfeedbackintemporealesullorooperatonelleprocedurechirurgiche

- G l i s tudent i bene f i c i ano d i unavisualizzazione ottimizzata del campooperatorionell’apprendimentochirurgicoduranteilloropercorsoformativo

- Ipazientipostchirurgicipossonoavereuncontattomoltopiùintensoconilmedico,prima impensabile per la difficoltà diaccesso agli ambulatori e al reparto.Questoèafavoresoprattuttodeipazientichenonhannolapossibilitàdispostarsiautonomamente

- Il tutto viene conseguito utilizzandotecnologieubiquitarieeadisposizioneditutti, come gli smartphone e i tablet,rendendoilprogettoSEFunasoluzioneflessibile e adattabile, con un costocontenuto.

SEF Project is designed to provide an integrated

telemedicine solution for telementoring, telesurgery and

teleassistance.

SEF Project optimizes the potential of widely available

devices, such as smartphones and tablets, and implements

Kramer® technology in order to support multiple video

streams, which are transmitted to an interactive touchscreen

whiteboard, located in remote spaces, such as meeting

rooms and university classrooms.

Methods:

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SEF Project allows to reproduce each

video stream on a separate screen

space. Therefore, many cameras can

simultaneously transmit up to 12

parallel channels. The integration with

VIA Kramer® software allows to mirror

digital contents from PC and Mac, such

as imaging data, virtual surgical

plannings, endoscopic procedures. Such

a virtual environment has a high

teaching efficacy for students and

residents.

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A virtual LAN (VLAN) consists of any

broadcast domain being partitioned and

isolated in a computer network at the data

link layer. LAN is the acronym for local area

network and in this context virtual refers to

a physical object recreated and altered by

additional logic. VLANs work by applying

tags to network packets and handling these

tags in networking systems – creating the

appearance and functionality of network

traffic that is physically on a single network

but acts as if it is split between separate

networks.

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Descrizione

Il progetto SEFpresentauna soluzioneditelemedicina integrata volta a fornire unapiattaformaall’avanguardiaperteledidattica,telechirurgiaeteleassistenza.Concepitoperottimizzarelepotenzialitàdidispositiviqualismartphone e tablet, il progetto SEFimplementa tecnologie per la gestione dimultipliflussivideochevengonotrasmessiauna lavagna interattiva multimediale,posizionata inuna sala riunioni remotaedestinataalladiscussionedicasicomplessi,nonchéall’apprendimentodeglistudentidimedicina. Mediante l’utilizzo della retereg iona le , è poss ib i le estendere lacomunicazione ad ospedali e cliniche peramplificareillavorointeam.L’adozioneditecnologiecloudconsentelacomunicazionecon il paziente postchirurgico a casa,maanche l’identificazione precoce di lesionisuscettibilidimaggioreattenzioneclinica,eunmutuofeedbacktraclinicieassistiti.

IWB - INTERACTIVE WHITHBOARD

multiple visualisation supports, each one located in a different room, building or hospital. For instance, surgery can be displayed in real time at university during maxillofacial surgery classes. Moreover, VIA Campus adds the support for third part meeting applications. This interface ena-

places at the same time.

IWB - INTERACTIVE WHITHBOARD

multiple visualisation supports, each one located in a different room, building or hospital. For instance, surgery can be displayed in real time at university during maxillofacial surgery classes. Moreover, VIA Campus adds the support for third part meeting applications. This interface ena-

places at the same time.

Interactive flat panel Operating room

Presentation switcher

Network switcher (VLAN)

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Risultati

Negli interventi chirurgici realizzati, latrasmissionefullHDhaottenutoun’immaginedialtaqualitàefluida.Nonsisonoverificatifenomeni di flickering o interruzioni. Latrasmissione è stata eseguita anche inrisoluzione4K,conlatenzeaumentaterispettoalfullHD.L’interventochirurgicoèrisultatopiùsicuroanchedalpuntodivistadelrischioinfettivoperilminorpersonaleinsalaoperatoria.L’apprezzamentodapartedeglistudentièstatovalutatoconunquestionarioa10puntichehaconsentitodiquantificarelapercezionedellateledidattica. Sommando i risultati nelleesperienzerealizzate,loscoreconclusivorisultaparia9/10,denotandoungrandeinteresseanche da parte della popolazione deglistudenti.

In all surgeries performed, the application of SEF

protocol was successful. Image quality was high,

with 4K resolution, no flickering or interruptions

happened. 4K added minor latency if compared with

fullHD.

Surgeries were safer because of inferior infectious

risk, being teletransmission of surgery useful to

decrease the number of personnel and students in

the operating room.

Students’ appraisal was estimated using a score,

which was calculated from precise questions (see

side table). Final satisfaction score was 9/10.

Results:

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The flexibility of SEF Project is suitable for multiple purposes:

Residents can have a real-time feedback during their surgical apprenticeship

Students have an optimized visualization of operating field when they assist surgical procedures, at the same time

improving comfortability of the surgical environment

Postsurgical patients can benefit from more intense post-surgical follow-up, with advantages for patients that are unable to

move and a higher eco-sustainability

Team-work between more centers is improved by remote telesurgery

All the mentioned features can be achieved with minimal installation effort and low cost. As SEF Project is based upon

ubiquitary technologies, pre-existing resources are employed and little investment is necessary. However, if more

sofisticated technologies are available, they can be interfaced with SEF Project in an integrated setting.

Conclusions:

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Scientific research

Paper accepted: International Journal of Medical Informatics:

“SEF Project in Oral and Maxillofacial Surgery (Smart videosurgery, Easy teleteaching

and Fast teleassistance)”

Abstract accepted for publication - 24th Congress of the European Association for Cranio Maxillo Facial Surgery

Official presentation for Udine Academic Hospital

Risultati

Negli interventi chirurgici realizzati, latrasmissionefullHDhaottenutoun’immaginedialtaqualitàefluida.Nonsisonoverificatifenomeni di flickering o interruzioni. Latrasmissione è stata eseguita anche inrisoluzione4K,conlatenzeaumentaterispettoalfullHD.L’interventochirurgicoèrisultatopiùsicuroanchedalpuntodivistadelrischioinfettivoperilminorpersonaleinsalaoperatoria.L’apprezzamentodapartedeglistudentièstatovalutatoconunquestionarioa10puntichehaconsentitodiquantificarelapercezionedellateledidattica. Sommando i risultati nelleesperienzerealizzate,loscoreconclusivorisultaparia9/10,denotandoungrandeinteresseanche da parte della popolazione deglistudenti.

Presented at 24th congress European Association for Cranio-Maxillo-Facial Surgery, Munich

Awarded as the best project for “Functional Projects” Category at 18th AIIC Challenge, Rome

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Contacts

Project coordinator:Prof. Massimo Robiony, Chair of Maxillofacial Surgery Clinic, University of Udinemassimo.robiony@uniud.it

Technical Advisor:Federico Bortuzzo, BlueDigit Informaticsinfo@bortuzzo.com

Scientific Advisor:Dott. Alessandro Tel, Maxillofacial Surgery Resident, University of Udinealessandro.tel@icloud.com