5G ultra-remote robot-assisted laparoscopic surgery in China

Zheng, Jilu; Wang, Yonghua; Zhang, Jian; Guo, Weidong; Yang, Xuecheng; Luo, Lei; Jiao, Wei; Hu, Xiao; Yu, Zongyi; Wang, Chen; Zhu, Ling; Yang, Ziyi; Zhang, Mingxin; Xie, Fei; Jia, Yuefeng; Li, Bin; Li, Zhiqiang; Dong, Qi; Niu, Haitao

doi:10.1007/s00464-020-07823-x

Cited by 101 publications

(91 citation statements)

References 32 publications

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“…The retinal specialist planned individual patient treatment approaches by swiping with his finger to define laser areas and caution zones (nonlaser areas) on a color fundus photograph China mobile core network 1, A computer on which a platform for remote computer control had been installed was located in the Peking Union Medical College Hospital (PUMCH) telemedicine center in Beijing, China, and was connected to the fifth-generation (5G) customer premises equipment (CPE) using an ethernet cable (4). The device received an image from the screen of the laser system (9). The retinal specialist was then able to remotely draw the laser treatment plan on this screen, and the resultant plant was transmitted back to the laser system ( 9) at the laser center in Huzhou, China.…”

Section: Teleophthalmology Interventionmentioning

confidence: 99%

Application of 5G Technology to Conduct Real-Time Teleretinal Laser Photocoagulation for the Treatment of Diabetic Retinopathy

et al. 2021

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IMPORTANCE Interest in teleophthalmology has been growing, especially during the COVID-19 pandemic. The advent of fifth-generation (5G) wireless systems has the potential to revolutionize teleophthalmology, but these systems have not previously been leveraged to conduct therapeutic telemedicine in the ophthalmology field.OBJECTIVE To assess the feasibility of 5G real-time laser photocoagulation as a telemedicine-based treatment for diabetic retinopathy (DR). DESIGN, SETTING, AND PARTICIPANTSThis was a prospective study involving a retinal specialist from the Peking Union Medical College Hospital in Beijing, China, who performed online 5G real-time navigated retinal laser photocoagulation to treat participants with proliferative or severe nonproliferative DR who had been recruited in the Huzhou First People's Hospital in Zhejiang Province, China, located 1200 km from Beijing from October 2019 to July 2020.INTERVENTIONS These teleretinal DR and laser management procedures were conducted using a teleophthalmology platform that used the videoconference platform for teleconsultation, after which telelaser planning and intervention were conducted with a laser system and a platform for remote computer control, which were connected via 5G networks. MAIN OUTCOMES AND MEASURES Diabetic eye prognosis and the real-time laser therapy transmission speed were evaluated.RESULTS A total of 6 participants (9 eyes) were included. Six eyes were treated via panretinal photocoagulation alone, while 1 eye underwent focal/grid photocoagulation and 2 eyes underwent both panretinal photocoagulation and focal/grid photocoagulation. The mean (SD) age was 53.7 (13.6) years (range, 32-67 years). The mean (SD) duration of diabetes was 14.3 (6.4) years (range, 3-20 years). The mean (SD) logMAR at baseline was 0.32 (0.20) (20/30 Snellen equivalent). Retinal telephotocoagulation operations were performed on all eyes without any noticeable delay during treatment. The mean (SD) number of panretinal photocoagulation laser spots per eye in 1 session was 913 (243). CONCLUSIONS AND RELEVANCEThis study introduces a novel teleophthalmology paradigm to treat DR at a distance. Applying novel technologies may continue to ensure that remote patients with DR and other conditions have access to essential health care. Further studies will be needed to compare this approach with the current standard of care to determine whether visual acuity or safety outcomes differ.

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Section: Teleophthalmology Interventionmentioning

confidence: 99%

Application of 5G Technology to Conduct Real-Time Teleretinal Laser Photocoagulation for the Treatment of Diabetic Retinopathy

et al. 2021

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“…To tackle clinical challenges in acute care of infectious diseases, convergent research areas of physical human-robot partnerships, including sensing, manipulation and autonomy, will enable highly flexible and versatile medical robots, with enhanced capabilities to feel, touch and decide. The robots featured in the figure : (1) robot-assisted ultrasound imaging for remote examination of lungs and hearth in patients with COVID-19 7 ; (2) robot-assisted remote trauma assessment, including ultrasound imaging to evaluate the severity of lung involvement in patients with COVID-19 20 ; (3) semi-automatic oropharyngeal-swab sampling used for COVID-19 testing 6 ; (4) nursing assistance provided through a teleoperated robotic platform 10 ; (5) medical staff using a robot to remotely control ventilators in intensive care units of patients with COVID-19 11 ; (6) robot-assisted surgery, where 5G technology was exploited to perform four ultra-remote laparoscopic procedures 16 ; (7) supervised autonomous soft-tissue surgery successfully tested on porcine bowel anastomosis 18 ; (8) robot-assisted endotracheal intubation 12 ; (9) endotracheal intubation performed via a soft robot that can grow into multiple branches through the respiratory airways 13 . Figure reproduced with permission from ref.…”

Section: Physical Human-robot Interaction For Clinical Care In Infectious Environmentsmentioning

confidence: 99%

“…10 , Springer Nature Ltd (4); ref. 16 , Springer Nature Ltd (6); ref. 12 , Elsevier (8); Hawkes Lab /David Haggerty and Luis Ramirez (9).…”

Section: Physical Human-robot Interaction For Clinical Care In Infectious Environmentsmentioning

confidence: 99%

“…Delegation to a robot typically raises questions of (1) how can the robot's task be specified clearly enough, so the robot knows exactly what to do; (2) how can one ensure that the robot will perform the specified task safely and correctly; and (3) how to manage unexpected events and uncertainty. A recent classification distinguished development in autonomous surgery 15 between level 0 (teleoperation) 16 and level 5 (full autonomy) 17 , with few systems reaching beyond level 2 for task autonomy, such as that for autonomous suturing 18 . Autonomous physical interactions with bony rigid tissue anatomy based on preoperative model acquisition and computer-assisted surgical planning have already improved surgical outcomes.…”

Section: Increased Autonomymentioning

confidence: 99%

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Physical human–robot interaction for clinical care in infectious environments

Lallo

Murphy

et al. 2021

Nat Mach Intell

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“…• The biggest barrier to further uptake remains the upfront costs of the machines and annual servicing charges, even though robots may offer savings for surgical departments in other ways, such as decreased length of stay 5…”

Section: Robotic Laparoscopic Proceduresmentioning

confidence: 99%