title: Telesurgery system with original-quality moving images over high-speed Internet: expansion within the Asia-Pacific region.
abstract: BACKGROUND
  Amid rapid changes in surgical techniques and patient care, education and training for the new generation of health care providers is of utmost importance. An international telesurgical system, which we established between Japan and Korea through super-fast broadband Internet without any loss of quality, was shown to be a powerful tool for this purpose. We attempted to expand our advanced system throughout the Asia-Pacific region and studied its usefulness.
  
  
  METHODS
  Kyushu University Hospital (Fukuoka, Japan) was linked to 33 medical institutions and meeting venues in China, Taiwan, Thailand, Vietnam, Singapore, and Australia by academic optic fiber network. Digital video signals were directly converted into Internet protocol, and cipher security programs were used to protect patient privacy.
  
  
  RESULTS
  Of 49 international surgical teleconferences conducted, 16 were real-time demonstrations of surgery, and 33 involved recorded videos. For 37 events, two stations were connected pier-to-pier, and for the remaining 12, multiple stations were connected. The network remained stable, and the time delay between stations was restricted to 0.3-1.0 seconds. Responding to questionnaires, 70.6% of participants rated the image quality as "very good," and 22.5% rated it "good."
  
  
  CONCLUSIONS
  We succeeded in establishing a high-quality telesurgical system in a wide area of the Asia-Pacific region, and this is the first time high-speed Internet technology has been applied to surgery on such a large scale. Because it is not only of high quality but also economical and easy to set up, we believe this system will promote efficient remote surgical education and active academic exchange worldwide.
authors: Department of Endoscopic Diagnostics and Therapeutics, Kyushu University Hospital, Fukuoka, Japan. shimizu@med.kyushu-u.ac.jp
authors: Shuji
authors: S
authors: Shimizu
authors: Naoki
authors: N
authors: Nakashima
authors: Koji
authors: K
authors: Okamura
authors: Ho-Seong
authors: HS
authors: Han
authors: Masao
authors: M
authors: Tanaka
mesh_terms: D001208:Asia; D001315:Australia; D020375:Education, Distance; D005336:Fiber Optic Technology; D013502:General Surgery / Q000193:education*; D006801:Humans; D020407:Internet; D019114:Remote Consultation; D013514:Surgical Procedures, Operative; D017216:Telemedicine; D014743:Videotape Recording