Singapore Witnesses World's First Transmission of Ophthalmology Surgery in 3d High Definition

In what could be one of medical science's most important innovations, Singapore and Japan joined hands to transmit a cataract surgery in 3D High Definition images over real-time across the two countries.

The surgery was carried out in Japan's Asahikawa Medical College on February 16, 2006, while an audience made up of doctors, nurses and members of the media watched the operation eagerly in Singapore on a big screen using special 3D glasses.

The one and half hour operation saw Dr Akitoshi Yoshida, chairman of the Department of Ophthalmology at Asahikawa Medical College, remove cataract and hemorrhage from both eyes of a 53-year-old Japanese patient.

The patient is diagnosed as suffering from proliferative diabetic retinopathy cataract and was conscious throughout the operation. He was under local anesthesia.

The successful vitreo-retinal surgery has done more than eliminate barriers to clear vision for one patient; it has removed a vital barrier to training and telemedicine for the medical community.

Hands-on surgical training opportunities are always limited. Surgeons under training may not always have access to actual surgical experience until they have gone through sufficient basic training and one-to-one observation of surgery to be able to operate safely on patients.

The 3D HD technology enhances the teaching of surgery versus the 2-D system. Audience currently can only view surgery using the standard 2-D transmission and screen thus missing a lot of the details important to microsurgery such as depth perception, fine surgical manoeuvres and techniques which can only be picked up in the surgeon's view through the microscope.

With the new technology, 3-dimensional images can now be delivered on screen to many doctors under training at the same time thus increasing the training potential and opportunities. At the same time, improved visualisation and depth perception will bring about better and safer training outcomes that will ultimately benefit patients.

With 3D stereoscopic High Definition transmission, doctors can now watch in greater details and depth than ever before an entire surgery performed by a skilled surgeon. This opens up tremendous training possibilities; a training surgeon does not have to be in the same time zone as his students. It also opens up possibilities for telemedicine, or treating when the patient and doctor are separated physically.

In particular, High Definition clarity and 3 dimensional visualisation is critical to the success and quality of eye surgery as the eye surgeon deals with incisions, retractions, tissue removal and suturing in millimetres precision.

This new platform also facilitates more accurate visualisation and diagnosis of eye conditions for patients from overseas. The technology allows for better communication with collaborating institutions on the co-management of patients who have undergone surgery or treatment in Singapore and returned to their home countries for further follow-up care.

A Project Involving Doctors, Research Institutes, Government Bodies And Corporations

This transmission was the result of nine months of hard work and collaboration among many parties.

The live surgery was transmitted from Asahikawa Medical College to Singapore National Eye Centre - a distance of 5,000 km - using Internet Protocol Multicast technology utilising a separate Internet Protocol Video Conferencing (IPVC) unit based on the H.264 standard for communication between doctors from AMC and SNEC.

The link setup for this experiment joins Asahikawa Medical College from the city of Asahikawa in Hokkaido, Japan, via a 155Mbps SONET link established between Japan's National Institute of information and Communication Technology and Singapore Advanced Research and Education Network. Starhub came in to bridge the last leg of the link to the Singapore National Eye Centre through Starhub's 155Mbps ATM cloud. (See attached network diagram)

The transmission is hosted by the Singapore National Eye Centre and Asahikawa Medical College of Hokkaido, Japan via the Asia Broadband Network, a new high-speed 155Mbps R&D link between Singapore and Japan.

Panasonic Systems Solutions Company, Japan, supplied the 3D-HD video system and software. The entire project is supported by the Infocomm Development Authority of Singapore, Ministry of Internal Affairs and Communications of Japan, Singapore Advanced Research and Education Network and its counterpart, National Institute of Information and Communication Technology, Japan.

The transmission is undertaken as part of the Asia Broadband Advanced IT Cooperative Experiments project promoted by the Ministry of Internal Affairs and Communications of Japan and the Infocomm Development Agency in Singapore and contributes towards the establishing of the international hub on global info-communications in Asia.

In all 50 million yen (about S$700,000) was spent in this first phase, which involves a series of three surgeries carried out in Japan and transmitted to Singapore. A total of 25 eye surgeons in the Singapore National Eye Centre will be evaluating the success of the transmissions.

The second phase would see the Singapore National Eye Centre armed with the ability to transmit 3D HD images. There are plans to transmit live surgery demonstrations to countries in the region.

Super Quality. Super Realistic.

Images are transmitted via two High Definition cameras embedded in a modified microscope.

Amplification was such that sutures the thinness of an eyelash appear to be as thick as dental floss.

The first part of the operation was the removal of the cataract. Here, the images came through very clear and well-defined and in realistic depth. Images of Professor Yoshida cutting a tunnel, cutting up the cataract, using a device to break up the cataract and suck out the cataract and injecting an artificial lens were received exceptionally.

Images from the second part of the operation were equally sharp, with Professor Yoshida using a cutter to cut away the hemorrhage.

Says Associate Professor Ang Chong Lye, Director, Singapore National Eye Centre, "We have never been able before to transmit 3D images in better quality than normal 2D broadcast and we are proud to do this as one part of a whole collaboration by a broad band of parties.

"It is realisation of a dream of doctors. This is the first time we see a surgery exactly as it is in real life. Now the audience sees it exactly as the surgeon sees it - with the same depth and the same realism. It is no longer flat images as seen when projected on a TV monitor. It is one more barrier removed in training and research. It is really a brave new frontier for medicine."

He added, "This is a nascent technology. The possibilities in information sharing are almost endless for the technology."

Says Associate Professor Francis Lee, President, Singapore Advanced Research and Education Network (SingaREN), "Seeing in 3D is very important for surgical work. This trial is about how technology can be used to better our lives and it's about cooperation between two countries. Today is a moment when technology and medical practitioners come together to pioneer a new leap forward. Singapore National Eye Centre has shown what is possible. To me, this is only the first step to more great things to come."

With the technology, Singapore National Eye Centre can host 3-D live surgery demonstration courses in the Centre to attract the hundreds and thousands of eye surgeons in the region who would not have access to this technology thus enhancing its role as a leader in regional medical education.

27th International Epilepsy Congress to be held in Singapore July 2007

The 27th International Epilepsy Congress will be held between July 8-12 2007 at Suntec Singapore International Convention and Exhibition Centre. This biennial Congress is one of the largest medical conventions W the world, dedicated to Epilepsy - a medico-social problem that may affect up to three percent of the population at some stages in their lives.

The event will be hosted by the Singapore Epilepsy Society (SES).and the Singapore Epilepsy Foundation (SEF), and organised by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (BE). Both ILAE and IBE are non-profit organizations with official links to the World Health Organization (WHO).

During this five-day Congress, more than 4000 delegates from over 100 countries are expected to attend. Building upon the success of previous international and regional congresses, the aim of this Congress is to facilitate further exchange of knowledge and sharing of experiences amongst clinicians, researchers and allied health professionals from different continents. The scientific and educational programme will cover cutting edge topics and provide clinical updates essential for the continuing professional development of clinicians specialising in Epilepsy. The progranune will also be broad enough for other clinicians such as neuros urgeons, paediatricians, radiologists, psychiatrists, as well as allied health professionals involved in epilepsy care to attend.

The Singapore Epilepsy Society (Singapore Chapter of the ILAE) and the Singapore Epilepsy Foundation (Singapore Chapter of IBE) hope to create a greater level of awareness of epilepsy in the local community. The staging of the International Epilepsy Congress in Singapore will further the goals and objectives of the two organizations. Both the Singapore Epilepsy Society and the Singapore Epilepsy Foundation along with the International League Against 'Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) are extremely grateful to the Singapore Tourism Board (STB) for its tremendous support and assistance in helping to bring the International Epilepsy Congress to Singapore; this being only the third time that the International Epilepsy Congress has been staged in Asia.

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