Design and implementation of a web-based system for intraoperative consultation.

Background: With the use of electronic information distribution and telecommunication technologies, surgical teleconsultation is possible as a vehicle for consulting with experts remotely without their physical presence in the operating room (OR). This study evaluated real-time teleconsultation from the OR to remote consultants in the Russian Research Center of Surgery, Moscow, Russia and the Fundeni Clinical Hospital, Bucharest, Romania.

Methods: We evaluated the effectiveness of teleconsultation using a secure website interface where consultants could navigate through multimedia-based electronic documentation of a surgical procedure and identify the anatomic landmarks underlying the need for consultation.

Objective assessment of training surgical skills using simulated tissue interface with real-time feedback.

Objective: We have shown previously that achieving competent performance of basic laparoscopic skills is possible in difficult conditions. We hypothesize that real-time performance feedback adds to the quality of proficiency-based simulator training for performance and forces applied to conventional surgical tools while tying square knots and running suture throws.

Design: A silk suture was preplaced on a simulated skin pad to assess incision closure by tying square knots and in separate trials to evaluate closure with the task of placing a running suture.

A surgical telemedicine clinic in a correctional setting.

The telemedicine network between Virginia Commonwealth University Health System (VCUHS) and the Department of Corrections in Virginia has seen a steady increase in the number of disciplines involved in consultation. Hardware integration and methodologies between VCUHS and correctional facilities were supported by Polycom videoconferencing technology. During consults, a VCUHS-based surgeon was provided with patient records, picture archiving and communication system images, and laboratory data or text reports sent by fax.

Remote video management for intraoperative consultation and surgical telepresence.

Telemedicine applications can connect surgeons from one operating room (OR) to a distant consultant. The additional capacity of telepresence provides remote consultants the ability to control their own view of the surgical field using robotic management of a network camera. The goal of this study was to compare access to surgical field by robotic camera versus image controlled by the surgeon using a camera mounted to the table.

Microgravity effects on fine motor skills: tying surgical knots during parabolic flight.

Introduction: The health provider on a space exploration mission cannot evacuate a patient to Earth. Contingency plans for medical intervention must be designed for autonomy. This study measured the effect of microgravity on performance of fine motor skills such as basic surgical tasks.

Evolution of telemedicine in Russia: the influence of the space program on modern telemedicine programs.

Telemedicine education and application throughout Russia has its roots in Russia's space program. The concepts of telemedicine have evolved during the course of 40 years of space exploration. This paper reviews the evolution of telemedicine and the achievements of the Soviet/Russian Space Program.