Transmission of Endoscopic Procedures Live to Medical Symposium in San Juan via Internet2
Dr. Takuji Gotoda explains a procedure from the Experimental Surgery Lab at the University of Puerto Rico School of Medicine
The RCMI Center for Information Architecture in Research collaborated with the Johns Hopkins Hospital and the Experimental Surgery Laboratory at the School of Medicine of the University of Puerto Rico (UPR) to transmit endoscopic procedures live from both institutions to the San Juan Intercontinental Hotel in San Juan, Puerto Rico. These activities were part of the symposium Endoscopic Imaging and Therapies for Gastrointestinal Neoplasias: Today and Tomorrow held on March 10th and 11th, 2008. This activity preceded the Viva la Vida 2008 Conference.
Dr. Marcia Canto explains an endoscopic procedure from The Johns Hopkins Hospital.
The Center provided overall technical assistance in the selection, installation, testing and implementation of streaming technologies, and provided hardware and personnel to operate the transmission site at the Experimental Surgery Lab and the receiving site at the hotel. Aníbal Vega-Montijo functioned as lead technologist of the project, while Myrna Agostini, Brenda Nieves and Alex Lora operated the hardware. Dr. José G. Conde provided general coordination of technology deployment, including activities with the University of Puerto Rico High-Performance Computing facility and Centennial de Puerto Rico, a local Internet service provider.
Dr. Sergey V. Kantsevoy performs a colon polypectomy at the Johns Hopkins Hospital.
The Johns Hopkins Digital Video Group, with assistance of Johns Hopkins Hospital IT and engineering staff, tested, installed and operated transmission technologies in that institution. Dale Roth Levitz, Senior Associate Producer of the Johns Hopkins Digital Media Group, managed these activities at the Hopkins sites. Technical staff at Hopkins involved at different stages of the project included Roy Shipley, David Rudich, Leonard Frankford, Eric Kuhn and Steven Franz.
Dr. John C. Clarke provided coordination during the event with assistance from site coordinators Dr. Eun Ji Shin, Dr. John Buscaglia and Ms. Levitz. Dr. Anthony N. Kalloo served as event chair and moderator.
Dr. Klaus Mergener and Dr. Priscilla Magno perform an endoscopic mucosal resection at the UPR Experimental Surgery Lab
Videoconference (H.323) and the Digital Video Transport System (DVTS) were the main technologies deployed for this event. Videoconference was used to provide video and audio for interaction between endoscopists at the remote sites and the audience at the hotel while performing the procedures. DVTS allowed transmission of uncompressed digital video, at full quality, directly from the endoscopes and other instrumentation used during the procedures to a projection screen at the hotel over the Internet2 at 30 Mbps. Videoconference and DVTS endoscopy streams from Hopkins were transmitted via Internet2 to the UPR network, since both Johns Hopkins and UPR are members of this consortium. Centennial de Puerto Rico provided a temporary connection between the Internet2 GigaPop located at the HPCf and the hotel to complete the pathway to display video streams from both remote sites.
Dr. John Busgaglia and Dr. Patrick Okolo perform an endoscopic procedure at the Johns Hopkins Hospital.
Demonstrations included chromoendoscopy, endoscopic submucosal dissection, confocal endomicroscopy, endoscopic ultrasound, peritoneoscopy via NOTES (Natural Orifice Translumenal Endoscopic Surgery), radiofrequency ablation and cryotherapy. These advanced endoscopic imaging technologies and therapies were presented by renowned international experts coming from Japan, Germany, and the United States. Also, this activity represented the first live-transmission of confocal endosmicroscopy and NOTES techniques ever performed during an educational program. The unique facilities of the Experimental Surgery Lab at the UPR School of Medicine provided a comfortable environment for the practice of endoscopic procedures and an excellent setup for real-time transmission of high-quality digital endoscopic images.
From left: Dr. Manuel Más, Aníbal Vega-Montijo and Alex Lora at the UPR School of Medicine Experimental Surgery Lab
The Center thanks Dr. Anthony N. Kalloo, Professor of Medicine and Chief, Division of Gastroenterology and Hepatology, Johns Hopkins Hospital; Dr. Marcia I. Canto, Associate Professor of Medicine and Oncology, Johns Hopkins School of Medicine; Dr. Priscilla Magno, Assistant Professor of Medicine, University of Puerto Rico School of Medicine and Visiting Assistant Professor of Medicine, Johns Hopkins University, and Dr. Manuel Más, Professor of Surgery and Director of the Experimental Surgery Laboratory at the University of Puerto Rico School of Medicine for this opportunity to collaborate.
