These two pictures demonstrate the differences in surgical wound between conventional open and endoscopic surgery. The big wound on your left was made by open surgery. In contrast, the same operation can now be performed with four tiny wounds shown on your right.
Menu for my presentation is as follows. First, I would like to explain what the endoscopic surgery is to the audience for the first place. Then, I will show you the current network system working in our hospital to send our surgical movies on real-time basis. After that, Mr. Uchikubo from Olympus Company will tell us about actual plan for the present project.
1Kyushu University UI project Kyudai Taro,2007Shuji Shimizu, MDDirector,Telemedicine Development Center of Asia,Kyushu University Hospital,Fukuoka, Japan
Shuji Shimizu, MDDirector,Telemedicine Development Center of Asia,Kyushu University Hospital,Fukuoka, JapanMay 9, 2013, Cali, ColumbiaRemote Medical Education in Asia-Pacific- Possible expansion to Columbia-
1000 km500 kmTokyoSeoulBeijingShanghaiTaipeiBusanFukuoka1500 kmSapporoOsakaJAPANJAPANCHINACHINAKOREAKOREAEast Asia
The World’s10 Hottest Cities1. Las Vegas/USA2.2. Fukuoka/JapanFukuoka/Japan3. Munich/Germany4. London/England5. Toulouse/France6. Nanchang/China7. Moscow/Russia8. Ghaziabad/India9. Goyang/Korea10.Florianopolis/Brazil1. Las Vegas/USA2.2. Fukuoka/JapanFukuoka/Japan3. Munich/Germany4. London/England5. Toulouse/France6. Nanchang/China7. Moscow/Russia8. Ghaziabad/India9. Goyang/Korea10.Florianopolis/BrazilJuly 2006
Surgical revolution: One exampleSurgical revolution: One exampleOpen Endoscopic
Benefits of Endoscopic SurgeryBenefits of Endoscopic SurgerySmallwoundOpen Endoscopic1 week after surgery Pain Walking Recovery
But, NOT popular in medical community yetWhy not?Why not?Remote education• New knowledge and procedures keep coming.• Young doctors do not have enough chances.• Save time & travel expenses• Scalability: Daily use & Large audienceHUGE demands in education!<Economical & Effective!>
Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002Situations dramatically changed in 2002We use BIG Internet!We use BIG Internet!Korea- Japan wasconnected with BigBroadbandNetwork (2G).Korea- Japan wasconnected with BigBroadbandNetwork (2G).JapanJapanKoreaKorea Hub inKyushuUniv.
Key technologiesKey technologies DVTS(Digital video transport system) Academic network(Research and education network)2000s
Actual bandwidth in each network0.430051015202530ISDN DVTSMbpsCompressed,degradedOriginalqualityD: DigitalV: VideoT: TransportS: SystemPoint 1: Big Broadband NetworkDigital VideoInternetMoving images
DVTS: Cheap and SimpleDV Camcoder DVTS PCMicrophoneUTP(Ethernet)AudioInternet• DVTS: free but powerful software• No special teleconferencing equipments>30Mbps>30MbpsCommercial network does not work!Commercial network does not work!Surgical instrumentIEEE1394
Point 2: Academic Networkfor Research and EducationColumbia: RENATAScience 1986, “Computer Networking for Scientists”
High-speed Network for R&E in JapanMinistry ofEducation• Government-funded • No commercial use• All national universities are connected• No additional cost if connected• Big Internet is ready to use anytime• Government-funded • No commercial use• All national universities are connected• No additional cost if connected• Big Internet is ready to use anytimePractical Telemedicine has started.
International academic network (APAN)All connectionfee is free!Asia-Pacific Advanced NetworkKyushu Univ.as secretariat
Taipei BeijingFukuoka Seoul2005.3.18The first multi-station teleconference by DVTSThe first multi-station teleconference by DVTSPancreatic Transplantation MeetingPancreatic Transplantation Meeting New technical breakthrough
KRKRChinaChinaGastric cancerIndonesiaIndonesiaThailandThailandIndiaIndiaVietnamVietnamMalaysiaMalaysiaJPJPTaiwanTaiwanSingaporeSingaporePhilippinesPhilippinesRecoveryLess costBack to workEndoscEarlyAdmissionRecurrenceDeathOpeAdvancedDiagnosis andtreatmentEarly detection is very important!
China-Japan Early Gastric CancerTeleconferenceTokyo/JPFukuoka/JPShanghai/CN2011.11.15Beijing/CNRegular meetingVideo
Continuous Medical Education in AsiaFukuoka, JP Cho Ray HospitalHo Chi Minh, VNCancer InstituteTokyo, JPShanghai, CN2009.6.26
Bariatric Surgery from AustraliaAdelaideFukuokaSingapore2005.11.16Learn from others easily
Endoscopic Demonstration with EuropeBangkok, THKyoto, JPHamburg, GR Kuala Lumpur, MY Taipei, TWXian, CNFukuoka, JPSeoul, KR2007.8• France• Italy• Belgium• Czech• Spain• NorwayVideo
First DVTS trials with Latin AmericaMXTX BRSeattleCLNot so good…U San Paolo, BR2009
Dr Miguel/BODr Pablo/ARDr Nicolas/CODr Mauricio/MX
Dr Franco/CLDr Carlos/BZDr Alberto/UYDr Gabriel/CRDr Carlos/BR
Visiting Latin America with engineersAlemana Hosp/CLUSP/BRUniv. of La Plata/ARINNSZ/MX
Endoscopy teleconf. with Central/Latin America2013.1HawaiiMexicoBrazilChileAPAN venue Dr Yao Dr UedoUNAM Dr TanimotoUERJ Dr FatimaREUNA Dr Ignacio
RENATA is expanding networkRENATA is expanding networkin Columbiain ColumbiaGood timing to start the project!You need…•Engineers (network & system)- who make it possible•Doctors (programs)- who make it meaningful
Engineers: Network to the very endEngineers: Network to the very end1) Internationalnetwork2) Domestic(NREN)•APAN•RedClaraRENATA/CORNP/BRInternet2/USNetworkPointBig academicnetworkConnectedto hospital?NetworkPoint3) HospitalNetworkPointSupport ofengineersBig enough and stable network at all stepsFirewall
Doctors: Make attractive programs• Surgery/Endoscopy• Cardiac intervention• Rehabilitation• Dental• Bird flu, SARS, HIV• Basic Science• Nursing• Medical students, etc.A lot more needs…
Cardiac Intervention: live demonstration2012.2.16APAN-Chiang MaiTaiwan Univ.Osaka Univ./JPSingapore Univ.Thai main venue
Team buildingTeam buildingNational RENEngineersLocal Engineer(Network &Audio-visual)The success depends on how good team you can make.MedicalDoctorsMedicalDoctorsLocal Engineer(Network &Audio-visual)National RENEngineers
Conclusions1. Quality preservation of moving imagetransmission is essential in telemedicine.2. R&E network has made the clear and smoothmedical streaming possible with low cost.3. Good time to foster continuous remote medicaleducation programs in Columbia.Let us start working together!