Using 3D for training of surgeonsMathy Vanbuel

Training Consultancy

Production Management

ATiT

Production

History in the Mirror, 2016

• Documentary on classroom practice

• Ministry of education, Flanders

Gynetics Product Wizard, 2015

• Aimed at IVF centres

• Integrated platform with video, animation

Medical Training Events

• Integra Ankle Arthrosis Training Event, Leuven

• Interactive HD Video links from multiple hospitals

Production ESGE2014: day 1 and 2

• 7 x 90 min live surgeries via videoconferencing (SD – 2 Mbps videoconference H.323) from 7 different surgical hospitals in Belgium

• 1 Operation theatre per hospital

Gent

Godinne

GentGent

Bonheiden

Liege

LeuvenBrussels

Production ESGE2014: day 3 and 4

• 2 x 240 mins live surgeries via satellite in HD-3D from 3 different surgical hospitals in Belgium

• Day 3: 1 Operation theatre in hospital A (Leuven)1 Operation theatre in hospital B (Leuven)

• Day 4: 4 Operation theatres in hospital C (Brussels)

Operation theatre

• 3D endoscopic image sources operated by surgeon:

• Storz (DVI-I 1080/60p line by line)

• Olympus (HD-SDI 1080/50i side by side)

• 3D field cameras Panasonic AG-3DA1 (HD-SDI 1080/50i side by side), operated by camera operator

• 3D Video mixers (cascaded)

• 3D monitors (surgeon + switcher)

• Headsets microphone surgeon

• Loudspeakers

• Audio mixer (n-1)

Video

OT6-9 4 x Camera Olympus Endoscopie: output 3D side by side Mixer SNG Square

2 x External camera 3D

Audio

Audio PGM (4 x OK) Microphone headset surgeon (OK 6-9) Audio mixer SNG Square

Hand mcrophone on stand (OK 6-9)

Audio return (From Brussels Square) Skype Headset surgeon (OK 6-9)

Alto speaker (OK 6-9)

Alternative audio return (option as “Intercom”) (From Brussels Square) GSM Headset surgeon (OK 6-9)

Alto speaker (OK 6-9)

Left eye Right eye

1080 px x 1920 px

1080 px x 1920 px

Transmission

• Mpeg4, 16 Mbps

• DVB-S2 Satellite one way A+V (even over short distance, due to the terrain)

• Audio return via IP phone with GSM back up

Reception and display

• Requirements:

• High definition

• No active viewing glasses (not manageable in a non permanent situation)

• One day: pola glasses (because of availability of branded glasses)

• Second day: Infitec technology (selective interference filters)

• 3 projectors (Left + Right + spare)

• High intensity projection needed (filters take light away)

Viewing

• Active glasses

• Expensive, noisy, faulty, heavy, uncomfortable

• Excellent discretion

• Pola glasses

• Cheap to produce (but quality matters: axis adjustment, quality of filter)

• Takes light away

• Requires special (expensive) screen

• Interference glasses

• Moderately expense (70 Euros piece)

• Recyclable (cleaning needed)

• Any white screen will do

Reactions

• Both technologies (polar and infitec) were received equally (but were we comparing like with like?)

• Satisfaction is almost 80 %

• Complains about:

• Disturbing light diffraction (doors opening and closing, room lights dimmed…)

• Nauseatic reaction to camera handling (endoscopy, tunneling effect)

• Surgeons: (small informal survey)

• 50% considers a major advantage,

• 30% does not see any advantage

• 20% gets nauseatic or is stereo blind

Conclusions

• High additional cost (about 50%)

• At all levels: installation, QA

• Lack of dominant standards causes technical challenges

• Capturing, recording and transmission, display, distribution

• The use of glasses is a big disadvantage

• Use in the OT is increasingly becoming a standard (but expensive) practice especially with operation robots (Da Vinci)