title: Robotic telesurgery: a real-world comparison of ground- and satellite-based internet performance.
abstract: BACKGROUND
  Telesurgery was performed with ground vs. satellite networks, and differing satellite bandwidths.
  
  
  METHODS
  The networks were compared during internal mammary artery (LIMA) dissection in pigs (n = 8). Length of LIMA dissected and surgical quality (five-point scale) were recorded. Also, satellite bandwidth was decreased (n = 7) to determine a limit for telesurgery.
  
  
  RESULTS
  No significant differences existed in LIMA dissection during the ground (4.3 +/- 0.5 cm) and satellite phases (5.4 +/- 1.1 cm; p > 0.05) or in quality of surgery, although latency on satellite was 10 times greater (55 vs. 600 ms). With decreasing satellite bandwidth, surgery was not possible below 3 Mb/s, and quality of surgery was significantly decreased comparing 9 Mb/s (4.38 +/- 0.66/5) to 3 Mb/s (4.10 +/- 0.80/5; p < 0.05).
  
  
  CONCLUSIONS
  Satellite communication is a viable telesurgical modality. Satellite bandwidth should be above 5 Mb/s during telesurgery if used primarily or as back-up.
authors.affiliation: Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada. raymanr@aol.com
authors.forename: R
authors.initials: R
authors.lastname: Rayman
authors.forename: K
authors.initials: K
authors.lastname: Croome
authors.forename: N
authors.initials: N
authors.lastname: Galbraith
authors.forename: R
authors.initials: R
authors.lastname: McClure
authors.forename: R
authors.initials: R
authors.lastname: Morady
authors.forename: S
authors.initials: S
authors.lastname: Peterson
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: V
authors.initials: V
authors.lastname: Subotic
authors.forename: A
authors.initials: A
authors.lastname: Van Wynsberghe
authors.forename: R
authors.initials: R
authors.lastname: Patel
authors.forename: S
authors.initials: S
authors.lastname: Primak
mesh_terms: D000818:Animals; D003195:Computer Communication Networks; D004210:Dissection / Q000379:methods; D020407:Internet; D008323:Mammary Arteries / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012371:Robotics; D017215:Satellite Communications; D013552:Swine; D017216:Telemedicine