GATOR: connecting integrated operating room solutions based on the IEEE 11073 SDC and ORiN standards

  • Johann Berger
  • Max Rockstroh
  • Erik Schreiber
  • Yukishige Yoshida
  • Jun Okamoto
  • Ken Masamune
  • Yoshihiro Muragaki
  • Thomas NeumuthEmail author
Original Article



Medical device interoperability in operating rooms (OR) provides advantages for both, patients and physicians. Several approaches were made to provide standards for successful device integration. However, with high heterogeneity of standards in the market, device vendors may reject these approaches. The aim of this work is therefore to provide a proof of concept for the connection of two promising integration solutions OR.NET and SCOT to increase vendor interest.


The connection of devices between both domains is targeted by implementing an application to map device capabilities between the IEEE 11073 SDC and ORiN standards. Potential properties of the respective architectures are defined. The connection was evaluated by latency measurements in a demonstrator setup utilizing an OR light as an exemplary device.


The latency measurements resulted in a similar transmission speed of the GATOR (53.0 ms) and direct SDC-to-SDC (38.0 ms) communication. Direct proprietary ORiN-to-ORiN communication was faster in any case (8.0 ms).


A connection between both standards was successfully achieved via the GATOR application. The results show comparable magnitudes of the communication between the standards compared to the direct standard-internal communication.


Operating room Interoperability ORiN IEEE 11073 SDC OR-integration 



This work received funding from the German Academic Exchange Service (DAAD) as part of the project Toward IEEE 11073 SDC over ORiN in the program Projektbezogener Personenaustausch Japan 2018. Grant No. 57402281, and partly supported by the project “Research and development of advanced medical devices and systems to achieve the future of medicine/Development of a smart treatment chamber for the improvement of both medical safety and efficiency” being carried out by AMED (Japan Agency for Medical Research and Development), and JSPS Bilateral Joint Research Projects. “Smart Cyber Operating Theater” and “SCOT” are registered trademarks of Tokyo Women’s Medical University, and “OPeLiNK” is registered trademark of DENSO Corporation

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

No research on humans and/or animals was conducted in this work.


  1. 1.
    Lesh K, Weininger S, Goldman JM, Wilson B, Himes G (2007) Medical device interoperability-assessing the environment. In: Joint workshop on high confidence medical devices, software, and systems and medical device plug-and-play interoperability (HCMDSS-MDPnP 2007), pp 3–12.
  2. 2.
    Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM (2006) A prospective study of patient safety in the operating room. Surgery 139:159–173. CrossRefPubMedGoogle Scholar
  3. 3.
    Hu YY, Arriaga AF, Roth EM, Peyre SE, Corso KA, Swanson RS, Osteen RT, Schmitt P, Bader AM, Zinner MJ, Greenberg CC (2012) Protecting patients from an unsafe system: the etiology and recovery of intra-operative deviations in care. Ann Surg 256:203–210. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Lemke HU, Vannier MW (2006) The operating room and the need for an IT infrastructure and standards. Int J CARS 1:117–121. CrossRefGoogle Scholar
  5. 5.
    Cleary K, Kinsella A, Mun SK (2005) OR 2020 workshop report: operating room of the future. Int Congr Ser 2005(1281):832–838. CrossRefGoogle Scholar
  6. 6.
    MD PnP Program. The medical device “plug-and-play” interoperability program. Accessed 05 Jan 2019
  7. 7.
    Sun M, Wang Q, Sha L (2007) Building reliable MD PnP systems. In: Joint workshop on high confidence medical devices, software, and systems and medical device plug-and-play interoperability (HCMDSS-MDPnP 2007), pp 104–110.
  8. 8.
    Pöhlsen S, Schlichting S, Strähle M, Franz F, Werner C (2009) A concept for a medical device plug-and-play architecture based on web services. In: ACM SIGBED review, special issue on the 2nd joint workshop on high confidence medical devices, software, and systems (HCMDSS) and medical device plug-and-play (MD PnP) interoperability, vol 6, no. 6. CrossRefGoogle Scholar
  9. 9.
    Arney D, Plourde J, Schrenker R, Mattegunta P, Whitehead SF, Goldman JM (2014) Design pillars for medical cyber-physical system middleware. In: 5th workshop on medical cyber-physical systems (OASIcs-OpenAccess series in informatics), vol 36, pp 124–132.
  10. 10.
    MD PnP Program. OpenICE. Accessed 05 Jan 2019
  11. 11.
    ASTM International, Medical Devices and Medical Systems: Essential safety requirements for equipment comprising the patient-centric integrated clinical environment (ICE)—Part 1: general requirements and conceptual model. Accessed 05 Jan 2019
  12. 12.
    Köny M, Benzko J, Czaplik M, Marschollek B, Walter M, Rossaint R, Radermacher K, Leonhardt S (2016) The smart operating room: smartOR. In: Distributed networks : intelligence, security, and applications. CRC Press, Boca Raton, FL, pp 291–316. CrossRefGoogle Scholar
  13. 13.
    TeKoMed. Technologische Kompatibilität in der Medizintechnik durch serviceorientierte Architekturen. Accessed 05 Jan 2019
  14. 14.
    Gessat M, Bohn S, Vorunganti A, Franke S, Burgert O (2011) TiCoLi: an open software infrastructure for device integration in the digital OR. Int J CARS 6:284Google Scholar
  15. 15.
    Kasparick M, Schmitz M, Andersen B, Rockstroh M, Franke S, Schlichting S, Golatowski F, Timmermann D (2018) OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability. Biomed Eng 63:11–30. CrossRefGoogle Scholar
  16. 16.
    Okamoto J, Masamune K, Iseki H, Muragaki Y (2018) Development concepts of a smart cyber operating theater (SCOT) using ORiN technology. Biomed Eng 63:31–37. CrossRefGoogle Scholar
  17. 17.
    Innovation Center Computer Assisted Surgery (ICCAS), Neumuth T. Sichere und dynamische Vernetzung in Operationssaal und Klinik – OR.NET Accessed 06 Jan 2019
  18. 18.
    Kasparick M, Schlichting S, Golatowski F, Timmermann D (2015) New IEEE 11073 standards for interoperable, networked point-of-care medical devices. In: 37th annual international conference of the IEEE Engineering in Medicine and Biology Society (EMBC) 2015, pp 1721–1724.
  19. 19.
    Janß A, Thorn J, Schmitz M, Mildner A, Dell’Anna-Pudlik J, Leucker M, Radermacher K (2018) Extended device profiles and testing procedures for the approval process of integrated medical devices using the IEEE 11073 communication standard. Biomed Eng 63:95–103. CrossRefGoogle Scholar
  20. 20.
    Kasparick M, Rockstroh M, Schlichting S, Golatowski F, Timmermann D (2016) Mechanism for safe remote activation of networked surgical and PoC devices using dynamic assignable controls. In: 38th annual international conference of the IEEE Engineering in Medicine and Biology Society (EMBC) 2016, pp 2390–2394.
  21. 21.
    Kasparick M, Schmitz M, Golatowski F, Timmermann D (2016) Dynamic remote control through service orchestration of point-of-care and surgical devices based on IEEE 11073 SDC. In: IEEE healthcare innovation point-of-care technologies conference (HI-POCT) 2016, pp 121–125.
  22. 22.
    Rockstroh M, Franke S, Hofer M, Will A, Kasparick M, Andersen B, Neumuth T (2017) OR. NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC. Int J CARS 12:1461–1469. CrossRefGoogle Scholar
  23. 23.
    Iseki H, Muragaki Y, Nakamura R, Ozawa N, Taniguchi H, Hori T, Takakura K (2005) Intelligent operating theater using intraoperative open-MRI. Magn Reson Med Sci 4:129–136. CrossRefPubMedGoogle Scholar
  24. 24.
    Mizukawa M, Matsuka H, Koyama T, Matsumoto A (2000) ORiN: open robot interface for the network, a proposed standard. Ind Robot Int J 27:344–350. CrossRefGoogle Scholar
  25. 25.
    Mizukawa M, Koyama T, Inukai T, Noda A, Kanamaru N, Noguchi Y, Otera N (2001) Proposal of open-network-interface for industrial robots (ORiN) and its experimental evaluation. In: Proceedings of the IEEE/ASME international conference on advanced intelligent mechatronics 2001, vol 2, pp 689–694.
  26. 26.
    Mizukawa M, Matsuka H, Koyama T, Inukai T, Noda A, Tezuka H, Yasuhiko N, Otera N (2002) ORiN: open robot interface for the network—the standard and unified network interface for industrial robot applications. In: Proceedings of the 41st SICE annual conference 2002, vol 2, pp 925–928.
  27. 27.
    Mizukawa M, Sakakibara S, Otera N (2004) Implementation and applications of open data network interface’ORiN’. In: SICE annual conference 2004, vol 2, pp 1340–1343Google Scholar
  28. 28.
    Masamune K, Nishikawa A, Kawai T, Horise Y, Iwamoto N (2018) The development of Smart Cyber Operating Theater (SCOT), an innovative medical robot architecture that can allow surgeons to freely select and connect master and slave telesurgical robots. Impact 2018:35–37. CrossRefGoogle Scholar
  29. 29.
    Microsoft. [MS-DCOM]: Distributed Component Object Model (DCOM) remote protocol. Accessed 07 Jan 2019
  30. 30.
    ORiN. Open Resource Interface for the Network. ORiN2.1 specifications. Part 1: Outline Version 2.1.0. Accessed 06 Jan 2019
  31. 31.
    Besting A, Stegemann D, Bürgerr S, Kasparick M, Strahen B, Portheine F (2017) Concepts for developing interoperable software frameworks implementing the new IEEE 11073 SDC standard family. In: 17th annual meeting of the International Society for Computer Assisted Orthopaedic Surgery (CAOS) 2017, EPiC Series in Health Sciences, vol 1, pp 258–263Google Scholar
  32. 32.
    SurgiTAIX AG. Service-oriented Device Connectivity Library (SDCLib/C). Accessed 05 Jan 2019
  33. 33.
    DENSO WAVE. ORiN2 SDK. Accessed 07 Jan 2019
  34. 34.
    ASELight. ASELight160 LED Operationsleuchte. Accessed 08 Jan 2019
  35. 35.
    Kasparick M, Beichler B, Konieczek B, Besting A, Rethfeldt M, Golatowski F, Timmermann D (2017) Measuring latencies of IEEE 11073 compliant service-oriented medical device stacks. In: 43rd annual conference of the IEEE industrial electronics society 2017, pp 8640–8647.
  36. 36.
    Ibach B, Benzko J, Schlichting S, Zimolong A, Radermacher K (2012) Integrating medical devices in the operating room using service-oriented architectures. Biomed Tech (Berl) 57(4):221–228. CrossRefGoogle Scholar
  37. 37.
    Vossel M, Strathen B, Kasparick M, Müller M, Radermacher K, de La Fuente M, Janß A (2017) Integration of robotic applications in open and safe medical device IT networks using IEEE 11073 SDC. In: Radermacher K, Rodriguez F, Baena Y (eds) CAOS2017. EPiC Series in Health Sciences, vol 1, pp 254–257.

Copyright information

© CARS 2019

Authors and Affiliations

  1. 1.Innovation Center Computer Assisted Surgery (ICCAS)University of LeipzigLeipzigGermany
  2. 2.Institute of Advanced Biomedical Engineering and ScienceTokyo Women’s Medical UniversityTokyoJapan
  3. 3.DENSO Wave IncorporatedAichiJapan

Personalised recommendations