Telementoring Demonstration in Craniofacial Surgery With HoloLens, Skype, and Three-Layer Facial Models

Abstract

Background: Telementoring is the technology for providing surgical instruction from a remote place via a network. To demonstrate the use of telementoring in craniofacial surgery, Skype and a mixed reality device HoloLens were adopted, and 3-layer facial models had been developed. Methods: A resident in hospital A used the model surgery under remote guidance by a mentor surgeon in hospital B 4 times on different dates. The straight-line between hospitals A and B is 250 km. The mentor gave the resident guidance via Skype and HoloLens, communicating by voice, and video of the surgical field, and providing reference data. Results: There was no delay in voice communication and a delay of <0.5 seconds in the video. The resident was able to confirm the main landmarks of the surgical field and to grasp the situation without problems. The mentor could send appropriate instructions by voice, could point out a specific part by telestration function, and could draw lines on the 2-dimentional images pasted on the operator's field of vision. Discussion: With the use of HoloLens, Skype, and the 3-layer models, it was possible to demonstrate telementoring. The risk of personal information leakage due to data interception seems to be very low because its data communication is encrypted with advanced encryption standard. Conclusion: This telementoring system has various advantages and many improvable aspects in the field of craniofacial surgery.

Navigating telemedicine for facial trauma during the COVID‐19 pandemic

“…Telementoring shown with the Mitsuno et al 18 study, was also highlighted in the Chiao et al 19 case report describing a telemedicine demonstration where a comprehensive examination of the eye with ultrasound was conducted by minimally‐trained crew members in space using reference cards, and real‐time guidance from a remote radiologist. This remote guidance yielded ocular images of diagnostic quality that could guide remote decision‐making—suggesting possible applications in craniofacial trauma patients with a remote expert guiding a responder in image acquisition 19 …”

“…Teleradiology was utilized in the evaluation of patients with facial trauma 15‐19 . Brucoli et al 15 retrospectively investigated the efficacy of teleradiology in triaging 605 traumatic facial fractures in 467 patients treated across 6 peripheral hospitals and a central maxillofacial surgery center.…”

“…Mitsuno et al 18 noted that telemedicine may have an expanding role in training and mentoring of surgeons treating facial trauma. Surgical models of the face were used in conjunction with shared real‐time video communication (Skype) and virtual surgical field marking through the head‐mounted, mixed reality device (Microsoft HoloLens).…”

Tele-mentoring using augmented reality technology in healthcare: A systematic review

“…In 19 (76%) of the experiments, a new AR prototype was developed, while the remaining (6 or 24%) used or modified AR devices developed by a third party. Microsoft HoloLens version 1 (Microsoft, 2019) was used in five experiments (Hanna et al, 2018;Lin et al, 2018;Mitsuno et al, 2019;Rojas-Munoz et al, 2018;Wang et al, 2017), and Google Glass (Google, n.d.) was used in one experiment (Ponce, Menendez et al, 2014).…”

Simulation Surgery Using 3D 3-layer Models for Congenital Anomaly

“…To demonstrate the use of telementoring in craniofacial surgery, we used Skype and a mixed reality device, HoloLens. 7 …”