Background Endoscopic treatment of Zenker’s diverticulum is an attractive minimally invasive alte... more Background Endoscopic treatment of Zenker’s diverticulum is an attractive minimally invasive alternative compared to the classic open approach. However, increased recurrence rate were reported. In case of relapse, endoscopic therapy might be repeated, or alternatively open surgery is performed. This study aimed to identify potential differences in the outcomes between primary or secondary surgical treatment in Zenker’s diverticulum. Methods From January 2003 to April 2019, 227 subsequent patients underwent surgical diverticulectomy and cervical myotomy at the surgical department of TUM. 41 of 227 patients had received previous therapy, either open or endoscopic. Perioperative parameters in priorly untreated patients were retrospectively compared to those after previous therapy (mostly endoscopic) with special regard to perioperative data and postoperative complications. Univariate and multivariate regression analyses were performed to identify predictors for postoperative complicati...
A growing body of evidence supports Virtual Reality (VR) as an effective and safe strategy for ma... more A growing body of evidence supports Virtual Reality (VR) as an effective and safe strategy for management of pain and stress associated with medical procedures in both adults and children. We therefore initiated a feasibility study to investigate the effect of VR on pain, stress, and anxiety during elective surgery, e.g. implantation of a central-venous port catheter, hypothesizing that VR can reduce intraoperative pain, stress and anxiety of the patient. In this manuscript, the preliminary results of the first 20 (out of 6o planned) patients are presented. Baseline pain characteristics did not differ between the two study groups (VR group (n=10) and standard (no VR device) group (n=10)). System usability (“easy to use”, “easy to learn” and “safe”) was rated “good - very good” by the study participants. Selfassessment of anxiety components (Y-6 item questionnaire) revealed a calming (3.3 ± 0.5 vs. 2.4 ± 0.5, P= 0.009) and relaxing (2.7 ± 1.2 vs. 1.8 ± 0.4; P=0.09) effect of the VR d...
Laparoscopic cholecystectomy (LCHE) is a widely employed model for surgical instrument and phase ... more Laparoscopic cholecystectomy (LCHE) is a widely employed model for surgical instrument and phase recognition in the field of machine learning (ML), with the latter being assigned to identify critical events and to avoid complications. Although ML algorithms have been proven to be effective for this instance and in selected patients, it is questionable whether patients receiving LCHE in daily clinical routine would actually benefit from adverse event prediction by ML applications. We believe, that the statistical problem of low prevalence (PREV) of potential adverse events in an unselected population and consequential low diagnostic yield was not considered adequately in recent research. Therefore, we performed a query to the G-DRG (German Diagnosis Related Groups) database of the German Federal Statistical Office with the aim to calculate prevalence of surgical and postoperative adverse events coming along with LCHE. The results enable an estimation of positive (PPV) and negative (N...
The major advantages of 5G networks for eHealth use cases are the low latency transmission and ne... more The major advantages of 5G networks for eHealth use cases are the low latency transmission and network slicing. In this paper, we explore the feasibility of using 5G to enhance remote mobile ultrasound. We demonstrate a medical use case to show how eHealth applications can be enhanced with 5G radio technology and network slicing. By using a flexible, reconfigurable test-bed, we examine the benefits of ultra low latency communications (URLLC) and slicing in a real world field test. This field test not only shows the advantages, but also reveals additional requirements of using 5G for eHealth sector. Our field test examines the impact of communication latency and slicing for performance evaluations. The reported results validate the feasibility of using 5G technology for eHealth applications. Meanwhile, comprehensive evaluations give the first impression of how 5G-enhanced eHealth applications perform in the real world scenario.
Hintergrund Die Digitalisierung ist in aller Munde und es ist zu erwarten, dass sich in den komme... more Hintergrund Die Digitalisierung ist in aller Munde und es ist zu erwarten, dass sich in den kommenden Jahren weitreichende Veränderungen auch im Gesundheitswesen und speziell in der Chirurgie ergeben werden. Neben allgemeinen Aspekten wie der elektronischen Patientenakte und dem Krankenhausinformationssystem werden artifizielle Intelligenz, Robotik und modellbasierte Chirurgie unser Tun maßgeblich beeinflussen. Um hierfür die notwendige Wissensbasis zu schaffen, Risiken und Chancen aufzuzeigen, aber auch um konkrete Handlungsfelder für die Chirurgie zu definieren, hat die Deutsche Gesellschaft für Chirurgie (DGCH) ein Positionspapier zur Digitalisierung beauftragt. Eine erste Bestandsaufnahme in Form einer Onlineumfrage ist Teil dieses Papiers und Inhalt dieses Artikels. Methodik Mithilfe einer onlinebasierten Umfrage unter den verfügbaren Mitgliedern der DGCH und ausgewählten Mitgliedern anderer Fachabteilungen wurde eine erste Bestandsaufnahme vorgenommen. Die Umfrage adressierte hierbei die persönliche Einschätzung hinsichtlich der Relevanz einzelner Bereiche der Digitalisierung, des diesbezüglichen Wissensstandes sowie der Auswirkung auf das chirurgische Tätigkeitsfeld. Ergebnis Insgesamt konnten 296 Mitglieder für die Umfrage gewonnen werden. Diese sehen die digitale Transformation aktuell noch mit Begriffen wie elektronische Patientenakte und Krankenhausinformationssystem verbunden, vermuten aber auch eine relevante Beeinflussung der eigenen Tätigkeit und des therapeutischen/operativen Bereiches. Der Wissenstand im Allgemeinen, vor allem aber in den chirurgisch relevanten Teilaspekten der Digitalisierung ist klar verbesserungswürdig. Die große Mehrzahl der Befragten sieht in der Digitalisierung eher eine Chance als ein Risiko. Schlussfolgerung Die Digitalisierung wird nach Ansicht der befragten Chirurgen in naher Zukunft auch die Chirurgie wesentlich verändern. Eine kompetente Begleitung der Umsetzung und Sicherung der chirurgischen Ansprüche wie auch der Patientensicherheit sollte unser aller Anliegen sein. Das Positionspapier kann hierfür als Basis dienen und soll konkrete Handlungsempfehlungen formulieren. Im Sinne einer akademischen Herangehensweise müssen wir die neuen Möglichkeiten hinsichtlich ihrer Eignung kritisch bewerten und gezielt nur dort einsetzen, wo sie tatsächlich von Nutzen sind – für uns und unsere Patienten. Background The digitalization process is currently on everyone’s lips and sweeping changes in the field of public health and especially in surgery are to be expected within the next few years. Besides general issues, such as electronic health records and medical information systems, artificial intelligence, robotics and model-based surgery will decisively impact on the daily routine. In order to provide the necessary knowledge base, to point out related risks and chances and also to define fields of action for surgery, the German Society of Surgery commissioned a position paper on digitalization. A first appraisal in form of an online survey is the subject of this article. Methods This article is based on an online survey of the members of the German Society of Surgery and selected members of other related societies. The survey asked for the members’ personal assessment concerning different aspects of the digitalization process and the respective state of knowledge as well as the impact on the field of surgery. Results A total of 296 members contributed to this survey. According to their assessment, digitalization in surgery is currently associated with terms such as electronic health records and medical information systems but they also assume a relevant influence on their own activities and on the fields of interventional medicine and surgery. A relevant need for improvement of the current state of knowledge was highlighted, not only for general aspects of digitalization but also for surgically relevant issues in particular. The vast majority of interviewed members saw digitalization more as a chance for improvement than as a risk factor. Conclusion According to the views of interviewed members of the German Society of Surgery the process of digital transformation will significantly impact the field of surgery. All those involved should feel responsible to contribute to and guide this process in order to maintain the surgically inherent requirements and to protect patient safety. The position paper on digitalization can serve as a basis and should define concrete recommendations for action. In the sense of an academic approach the new possibilities should be critically evaluated with respect to suitability and should be exclusively confined to applications that are beneficial to ourselves and to our patients.
Different components of the newly defined field of surgical data science have been under research... more Different components of the newly defined field of surgical data science have been under research at our groups for more than a decade now. In this paper, we describe our sensor-driven approaches to workflow recognition without the need for explicit models, and our current aim is to apply this knowledge to enable context-aware surgical assistance systems, such as a unified surgical display and robotic assistance systems. The methods we evaluated over time include dynamic time warping, hidden Markov models, random forests, and recently deep neural networks, specifically convolutional neural networks.
Die laparoskopische Myotomie gilt heute als Verfahren der Wahl fur die Therapie der Stadien I und... more Die laparoskopische Myotomie gilt heute als Verfahren der Wahl fur die Therapie der Stadien I und II der Achalasie, sofern es sich bei den Betroffenen um junge Patienten unter 40 Jahren handelt, wahrend bei alteren Patienten primar ein konservativer Behandlungsversuch (ein- bis zweimalige pneumatische Dilatation) infrage kommt. Im eigenen Krankengut wird etwa die Halfte der Patienten interventionell-endoskopisch und die andere Halfte chirurgisch behandelt. Der operative Eingriff der laparoskopischen Myotomie sollte mit einer Antirefluxmasnahme in Form einer Fundoplastik (nach Thal/Dor oder nach Toupet) kombiniert werden, um postoperativem Reflux vorzubeugen. Zudem soll sie narbenbedingte Rezidive verhindern. In der Literatur wird uber eine deutliche Verbesserung der klinischen Symptomatik nach diesem Eingriff in 74 – 95 % der nachuntersuchten Falle berichtet. Unter den Folgewirkungen sind Refluxbeschwerden relevant, die aber mit Protonenpumpenblockern gut behandelbar sind. Beim Stadium III der Achalasie („End-Stage-Achalasie“), das nach langjahrigem Verlauf der Krankheit etwa 5 % der Achalasie-Patienten betrifft, stellt eine Indikation fur ein radikaleres operatives Vorgehen im Sinne einer Osophagektomie dar. Grunde hierfur sind ein ausgedehnter und irreversibler Funktionsverlust der Speiserohre mit Syphonbildung, der durch eine Myotomie nicht mehr beeinflusst werden kann, sowie das deutlich erhohte Risiko, bei langjahrigem Verlauf der Achalasie ein Plattenepithelkarzinom zu entwickeln.
Information Processing in Computer-Assisted Interventions, 2014
Identifying and recognizing the workflow of surgical interventions is a field of growing interest... more Identifying and recognizing the workflow of surgical interventions is a field of growing interest. Several methods have been developed to identify intra-operative activities, detect common phases in the surgical workflow and combine the gained knowledge into Surgical Process Models. Numerous applications of this knowledge are conceivable, from semi-automatic report generation, teaching and objective surgeon evaluation to context-aware operating rooms and simulation of interventions to optimize the operating room layout.
BACKGROUND Digitalization affects almost every aspect of modern daily life including a growing nu... more BACKGROUND Digitalization affects almost every aspect of modern daily life including a growing number of healthcare services along with telemedicine applications. 5th. generation mobile communication technology (5G) has the potential to meet the requirements for this digitalized future with high bandwidths (10 GB/s), low latency (< 1ms) and high quality of service, enabling wireless real-time data transmission in telemedical emergency health care applications. OBJECTIVE We present the results of a 5G field test framework enabling preclinical diagnostics with mobile ultrasound for emergency patients using 5G network slicing technology. METHODS A bi-directional audio-video data transmission between ambulance car and hospital was established, combining both 5G-radio and -core network parts. Besides technical performance evaluations also medical assessment of transferred ultrasound image quality and transmission latency was examined. RESULTS Telemedical and clinical application prope...
INTRODUCTION 5th generation cellular mobile communications (5G) is one of the main requirements f... more INTRODUCTION 5th generation cellular mobile communications (5G) is one of the main requirements for the digital future. The new standard will offer high bandwidths (10GB/s), low latency (<1ms), and a high quality of service. It is not yet known whether 5G performance is sufficient for demanding eHealth applications (e.g., telemedicine). MATERIAL AND METHODS We evaluated 5G performance in two different medical applications (person/asset track & tracing and video data transmission for telesurgery) to appraise the impact of this new technology. In addition, a Delphi study was conducted evaluating the expectations and acceptance of 5G in the medical field in general. RESULTS Delphi study revealed that 5G has great potential for the future information transfer in the healthcare domain, and an increase of research activities for 5G applications in hospitals is needed. Clinical evaluation proved technical feasibility and accuracy of the 5G track & trace prototype solution. For the telep...
Einleitung: Die zunehmende Technisierung im OP ermöglicht die Entwicklung intelligenter Sicherhei... more Einleitung: Die zunehmende Technisierung im OP ermöglicht die Entwicklung intelligenter Sicherheits- Systeme. Voraussetzung ist eine umfassende Datenakquise, um Risiken zu identifizieren und Sicherheitsmechanismen einzuleiten. Es wurde ein Erfassungssystem für textile Materialien und Teambewegungen[for full text, please go to the a.m. URL]
ELITE: The Highly Immersive Phantom for Training and Simulation of NOTES. NOTES (Natural Orifice ... more ELITE: The Highly Immersive Phantom for Training and Simulation of NOTES. NOTES (Natural Orifice Translumenal Endoscopic Surgery) is an area of active research and has the potential to significantly advance the field of minimally invasive surgery and interventional endoscopy. Education and training are key issues when new surgical techniques are considered for introduction into clinical practice. The ELITE (Endoscopic-Laparoscopic Interdisciplinary Training Entity) trainer is an innovative ex vivo model comprising the highly immersive reconstruction of the abdominal anatomy to train NOTES techniques such as cholecystectomies, appendectomies, and other gastrointestinal resections. The aim of this study was to establish its validity and usefulness for training basic endoscopic, laparoscopic as well as particular NOTES skills. After proving its construct validation by means of performed studies that showed that all trainees (novices and endoscopic/laparoscopic experts) had a learning c...
International Journal of Computer Assisted Radiology and Surgery, 2021
The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. ... more The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. As operating room (OR) capacities are reduced everywhere to ensure availability of intensive care capacities, especially low-complex surgical procedures are often postponed. These include totally implantable central-venous access ports which are important for the oncologic treatment of cancer patients. In our study, we investigated the potential of an outpatient surgical centre (OSC) in terms of workflow effectiveness compared to the central operating room complex (COR) of a university hospital using low-complex surgical procedures as an example. Data of 524 consecutive patients who received a Port-a-cath procedure (422 implantations (80.5%) and 102 explantations (19.5%)) in our department between February 2019 and February 2020 were evaluated. A total of 277 patients were operated in outpatient surgical centre (OSC), and 247 patients received the procedure in the central OR (COR) comple...
Background Endoscopic treatment of Zenker’s diverticulum is an attractive minimally invasive alte... more Background Endoscopic treatment of Zenker’s diverticulum is an attractive minimally invasive alternative compared to the classic open approach. However, increased recurrence rate were reported. In case of relapse, endoscopic therapy might be repeated, or alternatively open surgery is performed. This study aimed to identify potential differences in the outcomes between primary or secondary surgical treatment in Zenker’s diverticulum. Methods From January 2003 to April 2019, 227 subsequent patients underwent surgical diverticulectomy and cervical myotomy at the surgical department of TUM. 41 of 227 patients had received previous therapy, either open or endoscopic. Perioperative parameters in priorly untreated patients were retrospectively compared to those after previous therapy (mostly endoscopic) with special regard to perioperative data and postoperative complications. Univariate and multivariate regression analyses were performed to identify predictors for postoperative complicati...
A growing body of evidence supports Virtual Reality (VR) as an effective and safe strategy for ma... more A growing body of evidence supports Virtual Reality (VR) as an effective and safe strategy for management of pain and stress associated with medical procedures in both adults and children. We therefore initiated a feasibility study to investigate the effect of VR on pain, stress, and anxiety during elective surgery, e.g. implantation of a central-venous port catheter, hypothesizing that VR can reduce intraoperative pain, stress and anxiety of the patient. In this manuscript, the preliminary results of the first 20 (out of 6o planned) patients are presented. Baseline pain characteristics did not differ between the two study groups (VR group (n=10) and standard (no VR device) group (n=10)). System usability (“easy to use”, “easy to learn” and “safe”) was rated “good - very good” by the study participants. Selfassessment of anxiety components (Y-6 item questionnaire) revealed a calming (3.3 ± 0.5 vs. 2.4 ± 0.5, P= 0.009) and relaxing (2.7 ± 1.2 vs. 1.8 ± 0.4; P=0.09) effect of the VR d...
Laparoscopic cholecystectomy (LCHE) is a widely employed model for surgical instrument and phase ... more Laparoscopic cholecystectomy (LCHE) is a widely employed model for surgical instrument and phase recognition in the field of machine learning (ML), with the latter being assigned to identify critical events and to avoid complications. Although ML algorithms have been proven to be effective for this instance and in selected patients, it is questionable whether patients receiving LCHE in daily clinical routine would actually benefit from adverse event prediction by ML applications. We believe, that the statistical problem of low prevalence (PREV) of potential adverse events in an unselected population and consequential low diagnostic yield was not considered adequately in recent research. Therefore, we performed a query to the G-DRG (German Diagnosis Related Groups) database of the German Federal Statistical Office with the aim to calculate prevalence of surgical and postoperative adverse events coming along with LCHE. The results enable an estimation of positive (PPV) and negative (N...
The major advantages of 5G networks for eHealth use cases are the low latency transmission and ne... more The major advantages of 5G networks for eHealth use cases are the low latency transmission and network slicing. In this paper, we explore the feasibility of using 5G to enhance remote mobile ultrasound. We demonstrate a medical use case to show how eHealth applications can be enhanced with 5G radio technology and network slicing. By using a flexible, reconfigurable test-bed, we examine the benefits of ultra low latency communications (URLLC) and slicing in a real world field test. This field test not only shows the advantages, but also reveals additional requirements of using 5G for eHealth sector. Our field test examines the impact of communication latency and slicing for performance evaluations. The reported results validate the feasibility of using 5G technology for eHealth applications. Meanwhile, comprehensive evaluations give the first impression of how 5G-enhanced eHealth applications perform in the real world scenario.
Hintergrund Die Digitalisierung ist in aller Munde und es ist zu erwarten, dass sich in den komme... more Hintergrund Die Digitalisierung ist in aller Munde und es ist zu erwarten, dass sich in den kommenden Jahren weitreichende Veränderungen auch im Gesundheitswesen und speziell in der Chirurgie ergeben werden. Neben allgemeinen Aspekten wie der elektronischen Patientenakte und dem Krankenhausinformationssystem werden artifizielle Intelligenz, Robotik und modellbasierte Chirurgie unser Tun maßgeblich beeinflussen. Um hierfür die notwendige Wissensbasis zu schaffen, Risiken und Chancen aufzuzeigen, aber auch um konkrete Handlungsfelder für die Chirurgie zu definieren, hat die Deutsche Gesellschaft für Chirurgie (DGCH) ein Positionspapier zur Digitalisierung beauftragt. Eine erste Bestandsaufnahme in Form einer Onlineumfrage ist Teil dieses Papiers und Inhalt dieses Artikels. Methodik Mithilfe einer onlinebasierten Umfrage unter den verfügbaren Mitgliedern der DGCH und ausgewählten Mitgliedern anderer Fachabteilungen wurde eine erste Bestandsaufnahme vorgenommen. Die Umfrage adressierte hierbei die persönliche Einschätzung hinsichtlich der Relevanz einzelner Bereiche der Digitalisierung, des diesbezüglichen Wissensstandes sowie der Auswirkung auf das chirurgische Tätigkeitsfeld. Ergebnis Insgesamt konnten 296 Mitglieder für die Umfrage gewonnen werden. Diese sehen die digitale Transformation aktuell noch mit Begriffen wie elektronische Patientenakte und Krankenhausinformationssystem verbunden, vermuten aber auch eine relevante Beeinflussung der eigenen Tätigkeit und des therapeutischen/operativen Bereiches. Der Wissenstand im Allgemeinen, vor allem aber in den chirurgisch relevanten Teilaspekten der Digitalisierung ist klar verbesserungswürdig. Die große Mehrzahl der Befragten sieht in der Digitalisierung eher eine Chance als ein Risiko. Schlussfolgerung Die Digitalisierung wird nach Ansicht der befragten Chirurgen in naher Zukunft auch die Chirurgie wesentlich verändern. Eine kompetente Begleitung der Umsetzung und Sicherung der chirurgischen Ansprüche wie auch der Patientensicherheit sollte unser aller Anliegen sein. Das Positionspapier kann hierfür als Basis dienen und soll konkrete Handlungsempfehlungen formulieren. Im Sinne einer akademischen Herangehensweise müssen wir die neuen Möglichkeiten hinsichtlich ihrer Eignung kritisch bewerten und gezielt nur dort einsetzen, wo sie tatsächlich von Nutzen sind – für uns und unsere Patienten. Background The digitalization process is currently on everyone’s lips and sweeping changes in the field of public health and especially in surgery are to be expected within the next few years. Besides general issues, such as electronic health records and medical information systems, artificial intelligence, robotics and model-based surgery will decisively impact on the daily routine. In order to provide the necessary knowledge base, to point out related risks and chances and also to define fields of action for surgery, the German Society of Surgery commissioned a position paper on digitalization. A first appraisal in form of an online survey is the subject of this article. Methods This article is based on an online survey of the members of the German Society of Surgery and selected members of other related societies. The survey asked for the members’ personal assessment concerning different aspects of the digitalization process and the respective state of knowledge as well as the impact on the field of surgery. Results A total of 296 members contributed to this survey. According to their assessment, digitalization in surgery is currently associated with terms such as electronic health records and medical information systems but they also assume a relevant influence on their own activities and on the fields of interventional medicine and surgery. A relevant need for improvement of the current state of knowledge was highlighted, not only for general aspects of digitalization but also for surgically relevant issues in particular. The vast majority of interviewed members saw digitalization more as a chance for improvement than as a risk factor. Conclusion According to the views of interviewed members of the German Society of Surgery the process of digital transformation will significantly impact the field of surgery. All those involved should feel responsible to contribute to and guide this process in order to maintain the surgically inherent requirements and to protect patient safety. The position paper on digitalization can serve as a basis and should define concrete recommendations for action. In the sense of an academic approach the new possibilities should be critically evaluated with respect to suitability and should be exclusively confined to applications that are beneficial to ourselves and to our patients.
Different components of the newly defined field of surgical data science have been under research... more Different components of the newly defined field of surgical data science have been under research at our groups for more than a decade now. In this paper, we describe our sensor-driven approaches to workflow recognition without the need for explicit models, and our current aim is to apply this knowledge to enable context-aware surgical assistance systems, such as a unified surgical display and robotic assistance systems. The methods we evaluated over time include dynamic time warping, hidden Markov models, random forests, and recently deep neural networks, specifically convolutional neural networks.
Die laparoskopische Myotomie gilt heute als Verfahren der Wahl fur die Therapie der Stadien I und... more Die laparoskopische Myotomie gilt heute als Verfahren der Wahl fur die Therapie der Stadien I und II der Achalasie, sofern es sich bei den Betroffenen um junge Patienten unter 40 Jahren handelt, wahrend bei alteren Patienten primar ein konservativer Behandlungsversuch (ein- bis zweimalige pneumatische Dilatation) infrage kommt. Im eigenen Krankengut wird etwa die Halfte der Patienten interventionell-endoskopisch und die andere Halfte chirurgisch behandelt. Der operative Eingriff der laparoskopischen Myotomie sollte mit einer Antirefluxmasnahme in Form einer Fundoplastik (nach Thal/Dor oder nach Toupet) kombiniert werden, um postoperativem Reflux vorzubeugen. Zudem soll sie narbenbedingte Rezidive verhindern. In der Literatur wird uber eine deutliche Verbesserung der klinischen Symptomatik nach diesem Eingriff in 74 – 95 % der nachuntersuchten Falle berichtet. Unter den Folgewirkungen sind Refluxbeschwerden relevant, die aber mit Protonenpumpenblockern gut behandelbar sind. Beim Stadium III der Achalasie („End-Stage-Achalasie“), das nach langjahrigem Verlauf der Krankheit etwa 5 % der Achalasie-Patienten betrifft, stellt eine Indikation fur ein radikaleres operatives Vorgehen im Sinne einer Osophagektomie dar. Grunde hierfur sind ein ausgedehnter und irreversibler Funktionsverlust der Speiserohre mit Syphonbildung, der durch eine Myotomie nicht mehr beeinflusst werden kann, sowie das deutlich erhohte Risiko, bei langjahrigem Verlauf der Achalasie ein Plattenepithelkarzinom zu entwickeln.
Information Processing in Computer-Assisted Interventions, 2014
Identifying and recognizing the workflow of surgical interventions is a field of growing interest... more Identifying and recognizing the workflow of surgical interventions is a field of growing interest. Several methods have been developed to identify intra-operative activities, detect common phases in the surgical workflow and combine the gained knowledge into Surgical Process Models. Numerous applications of this knowledge are conceivable, from semi-automatic report generation, teaching and objective surgeon evaluation to context-aware operating rooms and simulation of interventions to optimize the operating room layout.
BACKGROUND Digitalization affects almost every aspect of modern daily life including a growing nu... more BACKGROUND Digitalization affects almost every aspect of modern daily life including a growing number of healthcare services along with telemedicine applications. 5th. generation mobile communication technology (5G) has the potential to meet the requirements for this digitalized future with high bandwidths (10 GB/s), low latency (< 1ms) and high quality of service, enabling wireless real-time data transmission in telemedical emergency health care applications. OBJECTIVE We present the results of a 5G field test framework enabling preclinical diagnostics with mobile ultrasound for emergency patients using 5G network slicing technology. METHODS A bi-directional audio-video data transmission between ambulance car and hospital was established, combining both 5G-radio and -core network parts. Besides technical performance evaluations also medical assessment of transferred ultrasound image quality and transmission latency was examined. RESULTS Telemedical and clinical application prope...
INTRODUCTION 5th generation cellular mobile communications (5G) is one of the main requirements f... more INTRODUCTION 5th generation cellular mobile communications (5G) is one of the main requirements for the digital future. The new standard will offer high bandwidths (10GB/s), low latency (<1ms), and a high quality of service. It is not yet known whether 5G performance is sufficient for demanding eHealth applications (e.g., telemedicine). MATERIAL AND METHODS We evaluated 5G performance in two different medical applications (person/asset track & tracing and video data transmission for telesurgery) to appraise the impact of this new technology. In addition, a Delphi study was conducted evaluating the expectations and acceptance of 5G in the medical field in general. RESULTS Delphi study revealed that 5G has great potential for the future information transfer in the healthcare domain, and an increase of research activities for 5G applications in hospitals is needed. Clinical evaluation proved technical feasibility and accuracy of the 5G track & trace prototype solution. For the telep...
Einleitung: Die zunehmende Technisierung im OP ermöglicht die Entwicklung intelligenter Sicherhei... more Einleitung: Die zunehmende Technisierung im OP ermöglicht die Entwicklung intelligenter Sicherheits- Systeme. Voraussetzung ist eine umfassende Datenakquise, um Risiken zu identifizieren und Sicherheitsmechanismen einzuleiten. Es wurde ein Erfassungssystem für textile Materialien und Teambewegungen[for full text, please go to the a.m. URL]
ELITE: The Highly Immersive Phantom for Training and Simulation of NOTES. NOTES (Natural Orifice ... more ELITE: The Highly Immersive Phantom for Training and Simulation of NOTES. NOTES (Natural Orifice Translumenal Endoscopic Surgery) is an area of active research and has the potential to significantly advance the field of minimally invasive surgery and interventional endoscopy. Education and training are key issues when new surgical techniques are considered for introduction into clinical practice. The ELITE (Endoscopic-Laparoscopic Interdisciplinary Training Entity) trainer is an innovative ex vivo model comprising the highly immersive reconstruction of the abdominal anatomy to train NOTES techniques such as cholecystectomies, appendectomies, and other gastrointestinal resections. The aim of this study was to establish its validity and usefulness for training basic endoscopic, laparoscopic as well as particular NOTES skills. After proving its construct validation by means of performed studies that showed that all trainees (novices and endoscopic/laparoscopic experts) had a learning c...
International Journal of Computer Assisted Radiology and Surgery, 2021
The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. ... more The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. As operating room (OR) capacities are reduced everywhere to ensure availability of intensive care capacities, especially low-complex surgical procedures are often postponed. These include totally implantable central-venous access ports which are important for the oncologic treatment of cancer patients. In our study, we investigated the potential of an outpatient surgical centre (OSC) in terms of workflow effectiveness compared to the central operating room complex (COR) of a university hospital using low-complex surgical procedures as an example. Data of 524 consecutive patients who received a Port-a-cath procedure (422 implantations (80.5%) and 102 explantations (19.5%)) in our department between February 2019 and February 2020 were evaluated. A total of 277 patients were operated in outpatient surgical centre (OSC), and 247 patients received the procedure in the central OR (COR) comple...
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Papers by Michael Kranzfelder