Title:	THREE SYSTEMS FOR PERFORMING REMOTE-ECHOGRAPHY THROUGH AN INTERNET CONNECTION ON GEOGRAPHICALLY ISOLATED PATIENTS
Author(s):	Philippe Arbeille, Kathryn Zuj, Arnaud Saccomandi, Elise Andre, Eric de la Porte, Monica Georgescu
ISBN:	978-989-8533-48-7
Editors:	Piet Kommers and Pedro Isaías
Year:	2016
Edition:	Single
Keywords:	Tele-medicine; Tele-echography; Teleoperated probe; Remote guidance
Type:	Short Paper
First Page:	179
Last Page:	183
Language:	English
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Paper Abstract:	Objective: To evaluate the performance of tele-echography for routine use in isolated medical centers. Methods: Three tele-echography systems were used for deep (abdomen, pelvis, fetus organs) and peripheral organs (carotid arteries, leg vasculature, muscle): (a) a robotic arm holding an echographic probe, (b) an echograph with motorized probe, both controlled from the expert center, (c) remote guidance where the operator at the patient site hold and orientate the probe assisted by an expert via videoconference. Results: These methods were tested in the same medical center 60km away from the University hospital. A total of 340 remote echographic examinations were performed (41% teleoperated, 59% by remote guidance). The average examination time (15 to 25min) depended on the method used, anatomy, and echogenicity of the patient. The motorized probe and the robotic arm allowed the full control of the probe orientation necessary for obtaining correct deep organ views and provided diagnoses in 97% of cases. Similarly, the motorized probe was also used for superficial organ examinations. The use of remote guidance was sufficient for superficial vessel examinations and provided diagnoses in 98% of cases but was not adequate for deep organ examinations. Discussion: Both teleoperated systems provided control of the probe orientation for obtaining appropriate views of deep organs but the motorized probe (430g; 400cm3) was much more ergonomic than the robotic arm (3.5kg; 40x35x40cm3). Remote guidance was appropriate for superficial blood vessels; however, the motorized superficial probe was better for the assessment of small structures. The ability to control the echograph functions and settings made the remote echography quicker and more accurate.
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