The new age of Telemedicine, Telesurgery and Virtual Reality

Brussels 08 October 1997 During the International Symposium on Telemedicine, organised by the Belgian Armed Forces in Brussels on October 8th 1997, retired Colonel Richard M. Satava, Professor of Surgery at Yale University, used the Gulf War as an example to illustrate the impressive power of modern information technology and its implementation on military medicine. New approaches in health and trauma care slowly are breaking through. Medical care takers are forced to adapt to thinking in Information Age terms instead of clinging to traditional Industrial Age definitions.

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During the International Symposium on Telemedicine, organised by the Belgian Armed Forces in Brussels on October 8th 1997, retired Colonel Richard M. Satava, Professor of Surgery at Yale University, used the Gulf War as an example to illustrate the impressive power of modern information technology and its implementation on military medicine. New approaches in health and trauma care slowly are breaking through. Medical care takers are forced to adapt to thinking in Information Age terms instead of clinging to traditional Industrial Age definitions.

Battlefield and combat casualties care training has been one of the first application fields to benefit from the revolutionary opportunities telemedicine has to offer. It is only natural that civil medicine will be submitted to similar changes under the influence of the modern capabilities generated by various advanced technologies such as remote sensing and imaging, telepresence surgery, virtual endoscopy and virtual reality (VR) surgical simulators.

All these applications, mediated through the computer and information networks, reside under the general definition of telemedicine. Nevertheless, at the symposium, Colonel Satava indicated important distinctions between the notions of telemedicine, telesurgery and virtual reality. However related the three may be to each other, they each apply to a different section. Telemedicine covers a wide range of remote medical diagnostics and consultations, while telesurgery refers principally to a surgical operation over a telemedicine network.

As for Virtual Reality, this constitutes a technology with innumerable applications spreading also beyond the medical field. Surgeons already are using simulation procedures in virtual endoscopy, a technique that soon may replace current flexible endoscopy for diagnostic procedures, according to Richard Satava. The patient's CT or MRI scan is reconstructed in three dimensions enabling the physician to make a fly through the virtual organs. Just like ultrasound, it can provide a 3-D image for diagnosis of, for example, battlefield injuries.

Virtual Reality surgical simulators are equally useful in educational and training environments. With this device, the trainees are able to recreate the human anatomy from the Visible Human dataset presenting a virtual cadaver. In this way, they can study anatomy from a new perspective by flying inside and around the organs. They even can practice surgical procedures with a scalpel and clamps. According to Satava, evaluation of such simulators already takes place for combat casualty care training.

Remote diagnosis can be executed through a Personnel Status Monitor System for vital signs or 3-D tele-ultrasound for anatomic information. Richard Satava also described the Green Telepresence Surgery System as being one of the first systems for distant surgery. It includes both a surgical workstation with 3-D monitor and dexterous handles with force feedback and a remote worksite with a 3-D camera system and responsive manipulators with sensory input.

As it is, telemedicine seems to offer a promising infrastructure integrating telesurgical and virtual reality technologies to be used not only in military medicine but to improve the health care quality for every single patient. Learn more about the telemedicine age at the Medical Service site of the Belgian Armed Forces.


Leslie Versweyveld

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