title: Remote Sonography in Routine Clinical Practice Between Two Isolated Medical Centers and the University Hospital Using a Robotic Arm: A 1-Year Study.
abstract: BACKGROUND
  A robotic arm was developed by our laboratory for tele-operated echography on patients in locations isolated from a trained sonographer. The objective of the study was to evaluate, over a 1-year period, the use of the robotic arm for telesonography performed by a sonographer located at the University Hospital (Tours, France) on patients in two isolated medical centers 50 km away linked via the Internet.
  
  
  METHODS
  A nonsonographer operator (physician or paramedic) located the ultrasound probe attached to the robotic arm over the appropriate acoustic window for the organ of interest by rolling the whole robotic arm and mechanical support across the floor. The expert sonographer then telemanipulated the robotic arm via an Internet connection and adjusted the orientation of the probe until the most appropriate organ view for delivering a diagnosis was obtained.
  
  
  RESULTS
  Three hundred telesonography examinations were performed within 1 year: 68 (22.7%) on abdominal organs, 20 (6.7%) on pelvic organs, 138 (46%) on supraaortic vessels (carotid artery), 33 (11%) on the thyroid, 30 (10%) on leg veins, and 11 (3.7%) on the kidney and urinary tract. Telesonography could not be achieved in 10 of the 300 cases due to poor image quality on obese patients or those presenting poor echogenicity. These cases were re-examined at the university hospital by a sonographer. The rate of telesonography exams over the 1-year period was 1.5 per day for the "general population" medical site and 1 per week for the "elderly patient" medical site.
  
  
  CONCLUSIONS
  This study demonstrated that telesonography using a robotic arm can be routinely used for providing echographic diagnoses on patients isolated from imaging centers.
authors.affiliation: 1 UMPS-CERCOM Service d'Echographie Doppler, CHU Trousseau , Tours, France .
authors.forename: Monica
authors.initials: M
authors.lastname: Georgescu
authors.affiliation: 2 Maison de Sante Pluridisciplinaire , Richelieu, France .
authors.forename: Arnaud
authors.initials: A
authors.lastname: Sacccomandi
authors.affiliation: 3 Etablissement d'Hospitalisation pour Personnes Agées et Dependantes , Montoire sur Loir, France .
authors.forename: Bernard
authors.initials: B
authors.lastname: Baudron
authors.affiliation: 1 UMPS-CERCOM Service d'Echographie Doppler, CHU Trousseau , Tours, France .
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Arbeille
mesh_terms: D004867:Equipment Design; D006785:Hospitals, University; D006801:Humans; D019114:Remote Consultation / Q000295:instrumentation* / Q000379:methods*; D012371:Robotics; D019035:Rural Health Services / Q000458:organization & administration; D014463:Ultrasonography / Q000295:instrumentation* / Q000379:methods*
keywords: echography; robotic arm; tele-operation; telemedicine