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. 2016 Jun 13;5(6):58.
doi: 10.3390/jcm5060058.

Tele-Operated Echography and Remote Guidance for Performing Tele-Echography on Geographically Isolated Patients

Philippe Arbeille  1 , Kathryn Zuj  2 , Arnaud Saccomandi  3 , Elise Andre  4 , Cedric De La Porte  5 , Monica Georgescu  6
Affiliations

Tele-Operated Echography and Remote Guidance for Performing Tele-Echography on Geographically Isolated Patients

Philippe Arbeille et al. J Clin Med. .

Abstract

Objective: To evaluate the performance of three tele-echography systems for routine use in isolated medical centers.

Methods: Three systems were used for deep (abdomen, pelvis, fetal) and superficial (muscle, thyroid, carotid artery) examinations: (a) a robotic arm (RA) holding an echographic probe; (b) an echograph with a motorized probe (MP); and (c) remote guidance (RG) where the patient site operator performed the examination assisted by an expert via videoconference. All systems were tested in the same medical center located 60 km away from the university hospital.

Results: A total of 340 remote echography examinations were performed (41% RA and MP, 59% RG). MP and RA allowed full control of the probe orientation by the expert, and provided diagnoses in 97% of cases. The use of RG was sufficient for superficial vessel examinations and provided diagnoses in 98% of cases but was not suited for deep or superficial organs. Assessment of superficial organs was best accomplished using the MP.

Discussion: Both teleoperated systems provided control of the probe orientation by the expert necessary for obtaining appropriate views of deep organs but the MP was much more ergonomic and easier to use than the RA. RG was appropriate for superficial vessels while the MP was better for superficial volumic organs.

Keywords: remote guidance; tele-echography; tele-medicine; teleoperated probe.

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Figures

Figure 1
Figure 1
(a) Robotic arm (RA) suspended from its ground support and (b) located above a patient.
Figure 2
Figure 2
(a) RA expert center computer screen with video of the patient (left) and echographe screen (right); (b) Renal cyst image obtained using RA; (c) Carotid bifurcation with atheromatous plaque in color Doppler using RG.
Figure 3
Figure 3
(a) General view of the isolated site with the MP held motionless on the patient by the non-sonographer operator (GP); (b) Probe with transducer tele-operated inside; (c) The expert with the dummy probe in hand, echograph function/settings teleoperation keyboard, and screen with ambient video and echographic view.
Figure 4
Figure 4
(a) Expert center computer screen for the MP with video of the patient (left), hepatic vein Doppler (right), and probe engine interface (bottom right); (b) View of gallbladder with lithiasis inside; (c) View of a renal cyst.
Figure 5
Figure 5
(a) Remote guidance (RG) for carotid artery; (b) View of a carotid stenosis in color Doppler by RG; (c) Location of the probe for calf vein visualization with RG.
See this image and copyright information in PMC

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