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Clinical evaluation of tele-endoscopy using UMTS cellphones

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Abstract

Background

In the past years, various applications of telemedicine have been found. Especially teleconsulting or telementoring has been accepted as a possible answer to upcoming higher quality demands utilizing expert knowledge in everyday clinical routine.

In this work we investigate whether video transmission based on universal mobile telecommunication system (UMTS) by means of arthroscopic videos is clinically reasonable. Secondly, we examine the quality of the enabling technology especially for consolidated diagnostics and telementoring.

Methods

Twenty arthroscopic video streams with a length of 60 s of each sequence, showing endoscopic craniomaxillofacial interventions such as arthroscopies of the temoporomandibular joint or endoscopic assisted open reductions of mandibular head fractures, were hosted on a server and analyzed on a UMTS cellphone. Each of the arthroscopic video sequences was independently evaluated by two consultants and a medical expert in TMJ surgery. Quality aspects such as identifiability of anatomical details, instruments, and tasks, and pathology were assessed in a questionnaire. Stability of transmission and breakdowns were also registered.

Results

The median percentage of completely transmitted videos without interruption was 85 ± 12.5% (interquartile range, IQR). In 6.7% of all video transmissions, complete interruption resulted, requiring restart. Of anatomical structures, 60.7% were correctly identified, while in 39.3% an identification error was detected. Tasks and instruments were recognized in 92.4%. In 94.8%, pathologies could be correctly diagnosed.

Conclusions

The need for teleconsultation is given, since orientation in arthroscopy is difficult. UMTS-streamed endoscopic videos still have certain limitations regarding teleconsulting due to instability and delay. Nevertheless, the technology may currently be beneficial for teleteaching and could be used in the future in teleconsultation. Without affecting ongoing surgeries and with no special need for a lecture theater, this technology provides tele-education using standard hospital infrastructure.

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Acknowledgments

We thank Mobilkom Austria AG & Co KG (IS Technology Lab, Dipl.-Ing. Erich Koeck and collegues) for providing UMTS cellphones, as well as for their technical advice and support. This publication was supported by the Austrian Research Promotion Agency FFG, grant 818041B1, proposed and managed by Prof. Dr. Kurt Schicho.

Disclosures

Authors Rudolf Seemann, Godoberto Guevara, Gerhard Undt, Rolf Ewers, and Kurt Schicho have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. University Clinic of Oral and Maxillofacial Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Rudolf Seemann, Godoberto Guevara, Gerhard Undt, Rolf Ewers & Kurt Schicho

Authors
  1. Rudolf Seemann
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  2. Godoberto Guevara
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  3. Gerhard Undt
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  4. Rolf Ewers
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  5. Kurt Schicho
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Correspondence to Kurt Schicho.

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Seemann, R., Guevara, G., Undt, G. et al. Clinical evaluation of tele-endoscopy using UMTS cellphones. Surg Endosc 24, 2855–2859 (2010). https://doi.org/10.1007/s00464-010-1066-2

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  • DOI: https://doi.org/10.1007/s00464-010-1066-2

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