增强现实远程手术的有效性:从Covid-19大流行中吸取的教训

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引用次数: 0

摘要

虚拟现实(VR)是一种允许多种交互的人工模拟环境。增强现实(AR)是一种真实世界环境的交互式体验,其中物体通过计算机生成的感知信息得到增强[1,2]。这些概念的增强版本正在一些临床实践中使用。虚拟互动在场(VIP)是一种技术,通过该技术,远程外科医生可以同时看到彼此的视野,从而允许他们远程协作进行远程手术[3]。虚拟互动呈现和增强现实(VIPAR)平台允许外科医生从远程位置使用标准的互联网连接向当地外科医生提供实时帮助。大流行通常会导致对医疗服务的需求激增,通常会超过当地的能力。SARS-Cov-2的爆发对患者和卫生从业人员都是一个巨大的挑战。外科手术只保留给最严重的病例。长期封锁限制了患者前往不同医疗机构的机会。大多数专家学会建议实施远程医疗,并将远程医疗纳入COVID-19疫情应对系统[4]。远程医疗不仅包括会诊、放射诊断和临床随访,还包括外科手术和外科医生的辅助指导。远程医疗不再是未来的工具。在这种流行病使人际交往变得困难的目前情况下,这成为一种需要。自1878年以来,触觉、触觉技术和远程触觉技术就被预测出来了。如今,它可以提供更现实和“物理”的远程医患互动。自从2001年第一次成功的远程腹腔镜胆囊切除术以来,远程手术使得世界各地不同的外科医生之间的合作成为可能。这种远程协作有助于战区复杂的伤口修复。同样的概念也适用于一些高风险手术的管理,如COVID-19阳性患者的急诊手术[5,6]。远程外科也可以彻底改变培训观念。实时访问患者成像的三维重建和与同事的远程互动可以提供全面的高质量技能转移[7]。在2020年之前,远程外科手术一直是一项令人兴奋的技术,但存在不明确的点。远程指导手术的有限使用主要是由于缺乏患者的信任和高昂的费用。大流行的爆发教会了我们很多关于它的安全性和有效性的知识。如今,在所有限制区域,医疗服务随时都是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness of augmented reality telesurgery: Lessons learned from Covid-19 pandemic
Virtual reality (VR) is an artificially simulated environment that permits multiple interactions. Augmented reality (AR) is an interactive experience of a real-world environment where the objects are enhanced by computer-generated perceptual information [1,2]. Enhanced versions of these concepts were being used in several clinical practices. Virtual Interactive Presence (VIP) is a technology by which surgeons located remotely can simultaneously view each other's visual field, allowing them to telecollaborate long distance surgeries [3]. Virtual interactive presence and augmented reality (VIPAR) platform allows a surgeon from a remote location to deliver realtime assistance to a local surgeon using a standard internet connection. Pandemic typically led to a surge in demand for healthcare services overwhelming usually local capabilities. The SARS-Cov-2 outbreak was a big challenge for both patients and health practitioners. Surgical procedures were reserved only to most critical cases. Long lockdown limited patients’ access to different health facilities. Most of the savant societies recommended implementing telemedicine and incorporating telemedicine as part of COVID-19 outbreak response systems [4]. Telemedicine involves not only consultation, radiodiagnosis and clinical follow up but also surgical procedures and surgeon’s assisting guidance. Telemedicine is no longer a futuristic tool. It becomes a need in the present situation where human interaction has been made difficult by the pandemic. The touch sense haptic technology and teledactyl were predicted since 1878. Nowadays it may provide a more realistic and “physical” doctor- patient interaction remotely. Since the first successful tele-laparoscopic cholecystectomy in 2001, telesurgery allowed collaboration between different surgeons located distantly across world. This Tele-collaboration contributed to complex wound repairs in war zones. The same concept was useful in the management of some high-risk procedures such as emergency surgeries in COVID-19 positive patients [5,6]. Telesurgery could revolutionize training concept as well. Real-time access to three‐ dimensional reconstructions in patient imaging and remote interaction with colleagues may provide comprehensive high-quality skills transfer [7]. Before 2020, telesurgery was always an exciting technology but with unclear endpoints. The limited access to tele-guided procedures was mostly explained by the lack of patient’s trust and the high cost. The pandemic outbreak taught us a lot about its safety and effectiveness. Nowadays, health care delivery is feasible anytime in all restricted areas.
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