................................................................................................................................................... ....................................................................... ....................................................................... RESEARCH Original article " Wireless live streaming video of surgical operations: an evaluation of communication quality Armin Schneider à , Dirk Wilhelm Ãw , Dietrich Doll w , Uwe Rauschenbach z , Michael Finkenzeller z , Helga Wirnhier à , Klaus Illgner z and Hubertus Feussner Ãw à Workgroup MITI; w Department of Surgery, Klinikum r. d. Isar, Technische Universita ¨t Mu ¨nchen; z Siemens Corporate Technology, Munich, Germany Summary We evaluated a mobile video system for surgical teleconsultation. A video streaming server in the operating room transmitted video and audio to a hand-held computer (personal digital assistant [PDA]) over a wireless local area network. Two groups of 20 surgeons (each with 12 qualified surgeons and eight surgeons between the 2nd and the 4th year of training) participated in the tests. For voice transmission, correct understanding of numbers was achieved in 100% of the cases (n ¼ 1000) and 98% of medical terms (n ¼ 400). The quality of the video displayed on the PDA was assessed by the recognition of different operating room scenarios. Only 62% (SD 17) of the structures were identified clearly on the hand-held device (n ¼ 400). The accuracy improved to 78% (SD 15) (n ¼ 400) if the same scenario was observed on a larger (50 cm) video screen (Po0.001). Accuracy was significantly better if audio conversation was possible. The quality evaluation by the consultants showed that the PDA display size and quality were sufficient for clinical use. Introduction Teleconsultation is already used for intraoperative consultation of external experts who are not physi- cally present in the operating room. 1–3 The main disadvantage is that consultants need appropriate equipment in their offices or must go to a room equipped with telemedicine facilities. To overcome these limitations and to allow spontaneous video communication during routine clinical activities, we have developed a mobile videoconsultation system based on a hand-held computer connected to a wireless local area network (WLAN). This enables audio–video transmission from the operating theatre to be established as required. The first studies have demonstrated that wireless live streaming is helpful in the health-care sector 4,5 and can be useful for educational purposes. 6 We have evaluated the use of wireless live streaming for clinical and surgical purposes. Methods Operating room equipment A PC was installed as a streaming server, with a frame grabber board (Videum, Winnov, Santa Clara, California, USA) for capturing the audio and video data. The streamed video data were transmitted through a LAN at 100 Mbit/s. WLAN access points (Netgear MR314, Santa Clara, California, USA) were sited at various places and connected to the network. The access points were based on the IEEE 802.11b wireless standard and provided a connection speed of 11 Mbit/s. For security reasons, the 128-bit Wireless Journal of Telemedicine and Telecare 2007; 13: 391–396 Accepted 18 June 2007 Correspondence: Professor Dr med H Feussner, Department of Surgery, Technische Universita ¨t Mu ¨nchen, Ismaningerstrasse 22, Munich 81675, Germany (Fax: þ49 89 4140 6030; Email: feussner@chir.med.tu-muenchen.de) at Technical University of Munich University Library on November 3, 2016 jtt.sagepub.com Downloaded from