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Video Over IP Permits South Pole Surgery
Henry Malmgren writes "Last week at the South Pole research station, we successfully completed knee surgery using a video over IP link back to the United States. The article is light on technical details, but what we did was to use a Polycom VTC unit to send a video signal to Raytheon Polar Services HQ in Colorado. Our signal went primarily over a Marisat satellite at T1 speeds, and then HQ redistributed the video to Boston via a dedicated ISDN line. We had signal problems several times during the transmission with Marisat, so we had to switch to a NASA TDRS satellite towards the end of the surgery. We also used an Iridium phone as a voice backup for the times when we couldn't get decent quality over either bird. During the surgery there were three cameras that we used to send back video to the states. One was the built in camera on the VTC unit, a second was a handheld Sony 8mm unit, and a third was a black and white "Doc Cam". This was a head mounted camera with a LED light unit that was built on station by our Senior Communications Technican, Jon Berry. This allowed the transmission of video from the Doctor's perspective. Unfortunately, while the Doc cam worked great locally, and we got great recordings of the surgery from it, it didn't work well over the satellite link. The camera view jumped around so much that it didn't compress well over the satellite link. The best video was obtained by putting the hand held camera on a tall tripod which was able to look directly into the surgical wound."
I cannot remember the particulars, but this is quite an innovation since the last major medical emergency in the south pole. A scientist had breast cancer, and she ended up performing self chemo on herself. Imagine if they had this technology a few years sooner! Usually on slashdot all we hear is the typical Linux yaddyaddayadda (not that i dont appreciate that), but it is nice to hear such a great use of technology
"Martha Stewart can lick my Scrotum......do i have a scrotum?" -- Sharon Osbourne
Well, let's see...except for the facts that the surgery in the article was to repair a damaged tendon, and was not performed using arthroscopic techniques, and was not related to osteoarthritis, you're right on the money.
Oh wait, no you're not.
Why yes, I AM a rocket scientist!
So they had a wireless T1 link at the south pole and The best they could do in Boston was ISDN??? Maybe i should move to the Sou1th Pole, if the wireless offerings are that good!!
I'm actually surprised that there hasn't been more telesurgery experiments; I find the whole idea fascinating, and that the process can be made to work at all really amazing and impressive.
But I think that the referenced article had a better take on it than this posting, whose "additional technical details" are, at best, unintentionally misleading.
The implication of "video over IP" is that you did this over the public IP network, which in fact is not the case.
The fact that you did this over what was effectively a dedicated point-to-point link means that the use of the IP transport was irrelevant (worse; it added unnecessary overhead, subtracting from the total data rate).
I understand not wanting to risk someone's knee on a link succeptible to a DOS (or only succeptible as a result of a substantial investment of effort on the part of the attacker). But your posting implies that this is something which took place over the public Internet, or *could* take place over the public Internet, when it's not.
-- Terry
You had me at "T1 over satellite."
El Karma: excelente(principalmente la suma de moderación hecha a los comentarios de los usuarios)
I'm sorry to hear that.
Got friends?
What I'd like to see is a web cast of this sort of thing.
I have no sig
This was a head mounted camera with a LED light unit that was built on station by our Senior Communications Technican, Jon Berry.
.... uh... important stuff to frag^H^H^H^H do.
Now this is a Capital G Geek in the best of all possible meanings.
"You wanna what? OK, I got some LEDs and shit...(madly digging through toolbox).Some wires hmmm.. soldering iron over here. Right on surgical lamp, heh. One of these days you'll come up with a challenge for me. Hey, when you're done with the surgery, can we keep the T1 satellite link up for a few. I have some
Seriously, there's a guy who actually earned the "Senior" in his title.
The in-house doc will be some sort of generalist, probably with a special interest in "winter medicine" (i.e. altered physiology in cold conditions, and illnesses particular to such conditions).
They all have basic grounding in all areas of medicine, but could never safely practise on their own outside their specialty. Just the same as I couldn't take apart a car engine on my own, but with a video link a mechanic could talk me through it because I know how to use basic tools. It really is that simple.
This idea was invented by Shampoo.
I don't mean the story happening on July 5th, I mean in the transmission. I'd hate to be the surgeon cutting, like, even 100ms before I see what I'm cutting. I Take that back. I'd really hate to be the patient, being a surgeon can't be a bad thing, anyway you look at it. Seriously, anybody has numbers on this, or is it just something you get used too? Like if you had real long arms, impecceble vision, and had to operate 30,000km away..?
Now the surgeon can scratch his ass as much as he likes during surgery without having to wash his hands and change gloves.
Anyway, my sister is only 27 and she's had one hip replaced for two years; and needs the other done ASAP. So it's not only old people that have osteo or need joints replaced.[1]
I don't post this for pity, or anything, but more simply to point out that one of the most difficult things for my sister and I with this disease is that no one expects people as young as we are to have such substantial problems just walking around. So I have a bit of a vested interest in pointing out that although rare, it isn't just old people that have osteoarthritis. By the way, my dad and sister have also had several arthroscopic surgeries on their knees, elbows, ankles, and shoulders. They did seem to help at least for a limited amount of time. But the joints just keeps on falling apart and making bony grit that crunches around in there; so it's temporary at best. I did read about that recent study with interest, though.
[1] I should mention that my sister actually resists the "osteoarthritis" non-professional diagnosis of our genetic disorder. It has a real, technical name that's no more descriptive, in my opinion, than "osteoarthritis" actually is; but does have the virtue, in her opinion, of being harder to fail to take seriously. She claims the actual degree of our joint deterioration is much greater than that of, say, the average 70 year-old with osteo. I have no idea. It seems bad, but these are the only joints I've ever had. Our doctors have always said that it's very, very bad.
And so, this is the second time they've needed remote medical help because the doctor there wasn't capable of handling the job themselves. Seems to me that this will necessarily lead to the creation of the EMH (Emergency Medical Hologram). These South Pole people really need to talk to the Star Trek people and get to work.
They're doing an unfamiliar procedure by video. Any kind of "oops" prolly wouldn't look to good to the viewing public ;-)
Let me say up front that this is way cool.
But reading the summary, I kept expecting to hear how you ID'd the limo from the vanity plate.
Party on!
"Consider yourself a member of a virtual corporation with Mr. Torvalds as your Chief Executive Officer." - Linux Advocac
IP doesn't imply the Internet, of course.
IP was probably chosen because you could get an end to end link (most likely Ethernet at both ends of the satellite link). Satellite networks do clever things with TCP to make it work better on their high-latency links. Most video apps will be IP based these days, or require a single layer 2 (such as ISDN) end to end, which is restrictive.
"I can't give you a brain, so I'll give you a diploma" - The Great Oz (blatently stolen sig)
I blew mine out skiing. My uncle however blew his out on an icy sidewalk. The right twist and tension will take out a tendon preaty good. Plus remember these guys are more than scientists down there, they have to more or less run a city by themselves. Catch the Discovery Channel special sometime on the Doc that got breast cancer down there.
I mod down any one who says "I'm sure I will get modded down for this"
Another reason words in the US are mangled is because we didn't just have British English floating around here, we had a crapload of European languages and thus adopted and melded a lot of words from the other languages into our own version of English. Thus, words adopted from other languages probably aren't in their original form, and much of the words we take from English have been modified, or brand new words added all together. IIRC the USian English Vocabulary is much larger than what is used on the other side of the Atlantic.
What?
Intramural penguin football. Dar Gibson was a star punter. (Do you have any idea how hard it is to get a 65-pound Emperor between the uprights?)
If we could leverage the impressive amount of cpu power currently to be found for relatively low price to replace current compression techniques with hybrid realtime 3D + Video.
For instance, easy prediction models (like the arms/smocks of the doctors, scalpels, hemostats, suction tubes) could with signatures and then compress the difficult to predict stuff (patient's entrails) with compressed video. Contrast in most operating environments means that this shouldn't be too hard to do. Then at the video destination build real-time 3D models of the cut objects to fill in the video. This should dramatically cut down on the ammount of video which needs to be compressed and transmitted.
My $0.02 will always be worth more than your â0.02, so
So, the have people capable, but no facilities for it, how is a satellite connection with an experienced doctor in Boston going to help?
Free unix account: freeshell.org
(Always ask lots of questions - even if it pisses people off. If you don't like the setup (as in our situation) refuse to go along. In our case we told them to wait for the surgeon to arrive and be physically present in the operating room during the surgery. Who knows if he was mentally present, though.)
If you want to know more about life in antarctica, and the realities of being a doctor, a friend of mine resigned a top surgeon's job to spend a year in antartica as medical officer (plus dentist, plus hairdresser).
Great diary, the real issues of life at the south pole, great photos... have a read of Ingrid On Ice
I spent a lot of money on booze, birds and fast cars. The rest I just squandered. - George Best
Why is there a disproportionate amount of appendicitis cases in Antartica? Does anyone know?