Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 1

INSTITUTE OF LIVER & BILIARY SCIENCES New Delhi, IN

Tele‐Conference Cart‐Manish Dutta

The Institute of Liver & Biliary Sciences (ILBS) has beenestablished by the Government of NCT of Delhi as anautonomous institute.

The mission of ILBS is to become a dedicatedinternational centre of excellence for the diagnosis,management and advanced training & research in thefield of liver and biliary diseases.

The first phase of ILBS has 180 hospital beds, 74 ofwhich cater as intensive care (ICU) beds.

ILBS is a deemed University and aspires to become aunique model for an academic career both for thenational and international students and the faculty.

ILBS ‐ Introduction

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 2

Tele Conference Cart ‐ Requirement

Tele‐conference cart to cater to the Institute’s needs and specialties:

1. To enable live bi‐directional AV communicationand provide the ability to present a patient and share images and data with a remote location.

2. To integrate with medical equipments to show their live output along with the camera  feed for interaction.

3. Should be self‐contained with small footprint to fit in limited spaces of procedure rooms.

Tele Conference Cart ‐ Requirement

Tele‐conference cart shall be used to demonstrate the following procedures to remote locations:

1. Endoscopy, EUS, Colonoscopy.

2. ERCP, HVPG, TJLB, Interventional radiology.

3. Laparoscopy procedures.

4. Open Surgery and transplant such as kidney and liver.

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 3

Tele Conference Cart ‐ Solution

We have developed a cart with following keycomponents:

1. HD Video Conferencing: Vidyo Codec HD220 androuter at Kyushu University is being used formulti party conference with remote participants.

2. Scalar: To convert video inputs from virtually allsources into format compatible with Vidyo fortransmission. Key component of this generalpurpose cart.

3. Audio Mixer: To auto mix audio from multiplemics and Vidyo along with functionality ofacoustic echo cancellation (AEC).

Since complete Institute has centralised UPS supply, a dedicated UPS for cart was not provisioned.

Tele Conference Cart ‐ Components

1 VC Codec Vidyo HD‐2202 PTZ Camera Sony EVI‐HD7V3 Microphone Revolabs HD Dual4 Audio Mixer with AEC Extron DMP 1285 Video Switcher Extron DVS 6056 Speakers Sony SRS‐D57 Network Switch Netgear ProSafe 24

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 4

Tele Conference Cart ‐ Procedures Tested

Endoscopy, EUS, Colonoscopy

Scope Olympus CLV 180 

Pentax epk‐i

S‐Video

S‐Video

ERCP, HVPG, TJLB Floroscopy

Vitals Monitor

Olympus CLV 180 

Shimadzu

Philips

Olympus CLV 180 

VGA

VGA

S‐Video

Laparoscopy Scope 

C‐Arm

Wolf HD 

Philips BV Pulsera

DVI, Svideo

Composite

Tele Conference Cart – Under Process

Interventional Radiology

Floroscopy Shimadzu VGA

Surgery C‐Arm

IntraoperativeUltrasound 

SurgiCam

Philips BV Pulsera

Profocus 2202 

KLS Martin 

Composite

VGA, S‐Video 

S‐Video, Composite

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 5

H.264 Scalable Video Coding (SVC) protocol for  reduced bandwidth requirement

Full HD 1080p30 resolution conference

Multiple devices such as mobile phone, tablets and notebook can join the conference. (VidyoMobile, VidyoDesktop)

Web‐based control via VidyoPortal

One HDMI video input for camera and 2 display port for output. Content sharing through separate USB device.

VC Codec ‐ Vidyo HD‐220

Multi Input Scaler, Switcher with Picture in Picture (PIP)

Video Scaler – Extron DVS 605

Multiple standard support 

Accepts multiple analog inputs

Composite S‐Video

Component RGBs VGA

Accepts digital video inputs

HDMI DVI

Wide input resolution range 640x480 to 1920x1200

Web management interface

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 6

Audio Mixer – Extron DMP 128

Audio Digital Signal Processor 

Digital Matrix Processor with flexible routing and mixing capabilities.

12 mic/line inputs and 8 outputs.

Eight channels AEC ‐ Acoustic Echo Cancellation Web 

management interface

Connection Diagram

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 7

Live HVPG Session at 36th APAN conference South Korea20‐08‐2013

HVPG ‐ Requirements 

Fluoroscopy UXGA (4:3) 1600 x 1200 Analog‐ VGAVitals Monitor XGA (4:3) 1024 x 768 Analog‐ VGAPTZ Camera 1080p (16:9) 1920 x 1080 Digital‐ DVI

Video Outputs

Codec 1080p (16:9) 1920 x 1080 Digital‐ DVIMonitors 1080p (16:9) 1920 x 1080 Digital‐ HDMI

Video Input

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 8

HVPG ‐ Solution

2 Vidyo Rooms were created  for this conference:Room 1: For showing Floroscopy image along with Vitals Monitor. This was shown continuously throughout the session.Room 2: For showing faculty, procedure interaction and content.

Extron605

Waveform

VGA

VGAVGA

HDMI

VidyoHD 220

HDMI DVI Display

HDMI

NKN

Mic

Aux

Aux

Interaction

DMP with AEC

Aux

Control – Room1 Control – Room2

Skype + Coordination

VidyoHD 220

Content Sharing

Room 1 

Room 2 

Procedure Feed

Fluo

roscop

y

DVI

PTZ Camera

Aux

VGA

Procedure output

Interaction

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 9

HVPG ‐ Photographs

• Human Network ‐ Cooperation between engineers and medical staff is a key to success.

• Testing & preparation are essential.

• Remote participant coordination is a must.

HVPG ‐ Conclusion

Manish Dutta, Institute of Liver and Biliary Sciences

The 7th Asia Telemedicine Symposium, 2013 10

Thank You