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Aranda-García S, Otero-Agra M, Berlanga-Macías C, Rodríguez-Núñez A, Barcala-Furelos R, Domingo J, Seijas-Vijande A, Fernández-Méndez F. New communication tool for basic life support training: smart glasses. A quasi-experimental study. Med Intensiva 2024; 48:77-84. [PMID: 37923607 DOI: 10.1016/j.medine.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 11/07/2023]
Abstract
AIM To analyze the effectiveness of a teaching-learning methodology for teletraining in basic life support (BLS) based on communication through smart glasses. DESIGN Pilot quasi-experimental non-inferiority study. PARTICIPANTS Sixty college students. INTERVENTIONS Randomization of the participants in: tele-training through smart glasses (SG) and traditional training (C) groups. Both training sessions were very brief (less than 8 min) and included the same BLS content. In SG, the instructor trained through a video call with smart glasses. MAIN VARIABLES OF INTEREST The BLS protocol, the use of AED, the quality of resuscitation and the response times were evaluated. RESULTS In most of the BLS protocol variables, the resuscitation quality and performance times, there were no statistically significant differences between groups. There were significant differences (in favor of the SG) in the assessment of breathing (SG: 100%, C: 81%; p = 0.013), the not-to-touch warning before applying the shock (SG: 79%, C: 52%; p = 0.025) and compressions with correct recoil (SG: 85%, C: 32%; p = 0.008). CONCLUSIONS Laypeople BLS-AED brief tele-training through smart glasses could potentially be, at least, as effective as traditional training methods. In addition, smart glasses could be more advantageous than traditional teaching for certain points of the BLS protocol and chest compressions quality, probably due to the capability of real-time visualization of images which supports the BLS sequence. Augmented reality supported teaching should be considered for BLS training, although caution is required in extrapolating findings, and further in-depth studies are needed to confirm its potential role depending on concrete target populations and environments.
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Affiliation(s)
- Silvia Aranda-García
- Grupo de Investigación GRAFAIS, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain; Grupo de Investigación CLINURSID, Facultad de Enfermería, Universidad de Santiago de Compostela, Santiago de Compostela, Spain
| | - Martín Otero-Agra
- Grupo de Investigación REMOSS, Facultad de Ciencias de la Educación y del Deporte, Universidad de Vigo, Pontevedra, Spain; Escuela de Enfermería de Pontevedra, Universidade de Vigo, Pontevedra, Spain
| | - Carlos Berlanga-Macías
- Centro de Estudios Socio-Sanitarios, Universidad de Castilla-La Mancha, Cuenca, Spain; Facultad de Enfermería, Universidad de Castilla-La Mancha, Albacete, Spain.
| | - Antonio Rodríguez-Núñez
- Grupo de Investigación CLINURSID, Facultad de Enfermería, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Investigación en Simulación, Soporte Vital y Cuidados Intensivos (SICRUS), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Sección de Pediatría Crítica, Cuidados Intermedios y Paliativos Pediátricos. Hospital Clínico Universitario de Santiago, Santiago de Compostela España, Spain; RICORS de Intervenciones en Atención Primaria para prevenir las enfermedades maternas e infantiles crónicas de origen perinatal y del desarrollo, RD21/0012/0025, Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Barcala-Furelos
- Grupo de Investigación REMOSS, Facultad de Ciencias de la Educación y del Deporte, Universidad de Vigo, Pontevedra, Spain
| | - Júlia Domingo
- Grupo de Investigación GRAFAIS, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | | | - Felipe Fernández-Méndez
- Grupo de Investigación CLINURSID, Facultad de Enfermería, Universidad de Santiago de Compostela, Santiago de Compostela, Spain; Grupo de Investigación REMOSS, Facultad de Ciencias de la Educación y del Deporte, Universidad de Vigo, Pontevedra, Spain; Escuela de Enfermería de Pontevedra, Universidade de Vigo, Pontevedra, Spain; Grupo de Investigación en Simulación, Soporte Vital y Cuidados Intensivos (SICRUS), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Biancheri P, Soriani P, Gabbani T, Bonura GF, Manno M. Smart glasses: Taking GI endoscopy to the metaverse era. Dig Liver Dis 2023; 55:692-693. [PMID: 36849287 DOI: 10.1016/j.dld.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Paolo Biancheri
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Via Molinari 2, 41012 Carpi (MO), Italy.
| | - Paola Soriani
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Via Molinari 2, 41012 Carpi (MO), Italy
| | - Tommaso Gabbani
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Via Molinari 2, 41012 Carpi (MO), Italy
| | - Giuliano Francesco Bonura
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Via Molinari 2, 41012 Carpi (MO), Italy
| | - Mauro Manno
- Gastroenterology and Digestive Endoscopy Unit, Azienda USL di Modena, Via Molinari 2, 41012 Carpi (MO), Italy
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Baashar Y, Alkawsi G, Wan Ahmad WN, Alomari MA, Alhussian H, Tiong SK. Towards Wearable Augmented Reality in Healthcare: A Comparative Survey and Analysis of Head-Mounted Displays. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3940. [PMID: 36900951 PMCID: PMC10002206 DOI: 10.3390/ijerph20053940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Head-mounted displays (HMDs) have the potential to greatly impact the surgical field by maintaining sterile conditions in healthcare environments. Google Glass (GG) and Microsoft HoloLens (MH) are examples of optical HMDs. In this comparative survey related to wearable augmented reality (AR) technology in the medical field, we examine the current developments in wearable AR technology, as well as the medical aspects, with a specific emphasis on smart glasses and HoloLens. The authors searched recent articles (between 2017 and 2022) in the PubMed, Web of Science, Scopus, and ScienceDirect databases and a total of 37 relevant studies were considered for this analysis. The selected studies were divided into two main groups; 15 of the studies (around 41%) focused on smart glasses (e.g., Google Glass) and 22 (59%) focused on Microsoft HoloLens. Google Glass was used in various surgical specialities and preoperative settings, namely dermatology visits and nursing skill training. Moreover, Microsoft HoloLens was used in telepresence applications and holographic navigation of shoulder and gait impairment rehabilitation, among others. However, some limitations were associated with their use, such as low battery life, limited memory size, and possible ocular pain. Promising results were obtained by different studies regarding the feasibility, usability, and acceptability of using both Google Glass and Microsoft HoloLens in patient-centric settings as well as medical education and training. Further work and development of rigorous research designs are required to evaluate the efficacy and cost-effectiveness of wearable AR devices in the future.
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Affiliation(s)
- Yahia Baashar
- Faculty of Computing and Informatics, Universiti Malaysia Sabah (UMS), Labuan 87000, Malaysia
| | - Gamal Alkawsi
- Institute of Sustainable Energy (ISE), Universiti Tenaga Nasional, Kajang 43000, Malaysia
- Faculty of Computer Science and Information Systems, Thamar University, Thamar 87246, Yemen
| | | | - Mohammad Ahmed Alomari
- Institute of Informatics and Computing in Energy, Universiti Tenaga Nasional (UNITEN), Kajang 43000, Malaysia
| | - Hitham Alhussian
- Department of Computer and Information Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia
| | - Sieh Kiong Tiong
- Institute of Sustainable Energy (ISE), Universiti Tenaga Nasional, Kajang 43000, Malaysia
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Sparwasser P, Haack M, Frey L, Boehm K, Boedecker C, Huber T, Stroh K, Brandt MP, Mager R, Höfner T, Tsaur I, Haferkamp A, Borgmann H. Assessment of a novel smartglass-based point-of-care fusion approach for mixed reality-assisted targeted prostate biopsy: A pilot proof-of-concept study. Front Surg 2022; 9:892170. [PMID: 35937598 PMCID: PMC9354482 DOI: 10.3389/fsurg.2022.892170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose While several biopsy techniques and platforms for magnetic resonance imaging (MRI)-guided targeted biopsy of the prostate have been established, none of them has proven definite superiority. Augmented and virtual reality (mixed reality) smartglasses have emerged as an innovative technology to support image-guidance and optimize accuracy during medical interventions. We aimed to investigate the benefits of smartglasses for MRI-guided mixed reality-assisted cognitive targeted biopsy of the prostate. Methods For prospectively collected patients with suspect prostate PIRADS lesions, multiparametric MRI was uploaded to a smartglass (Microsoft® Hololens I), and smartglass-assisted targeted biopsy (SMART TB) of the prostate was executed by generation of a cognitive fusion technology at the point-of-care. Detection rates of prostate cancer (PCA) were compared between SMART TB and 12-core systematic biopsy. Assessment of SMART-TB was executed by the two performing surgeons based on 10 domains on a 10-point scale ranging from bad (1) to excellent (10). Results SMART TB and systematic biopsy of the prostate were performed for 10 patients with a total of 17 suspect PIRADS lesions (PIRADS 3, n = 6; PIRADS 4, n = 6; PIRADS 5, n = 5). PCA detection rate per core was significant (p < 0.05) higher for SMART TB (47%) than for systematic biopsy (19%). Likelihood for PCA according to each core of a PIRADS lesion (17%, PIRADS 3; 58%, PIRADS 4; 67%, PIRADS 5) demonstrated convenient accuracy. Feasibility scores for SMART TB were high for practicality (10), multitasking (10), execution speed (9), comfort (8), improvement of surgery (8) and image quality (8), medium for physical stress (6) and device handling (6) and low for device weight (5) and battery autonomy (4). Conclusion SMART TB has the potential to increase accuracy for PCA detection and might enhance cognitive MRI-guided targeted prostate biopsy in the future.
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Affiliation(s)
- P. Sparwasser
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
- Correspondence: Peter Sparwasser
| | - M. Haack
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - L. Frey
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - K. Boehm
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - C. Boedecker
- Department of General, Visceral and Transplant Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - T. Huber
- Department of General, Visceral and Transplant Surgery, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - K. Stroh
- Department of Radiology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - M. P. Brandt
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - R. Mager
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - T. Höfner
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - I. Tsaur
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - A. Haferkamp
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
| | - H. Borgmann
- Department of Urology, University Medical Center Johannes Gutenberg University, Mainz, Germany
- Department of Urology, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Rai AT, Deib G, Smith D, Boo S. Teleproctoring for Neurovascular Procedures: Demonstration of Concept Using Optical See-Through Head-Mounted Display, Interactive Mixed Reality, and Virtual Space Sharing-A Critical Need Highlighted by the COVID-19 Pandemic. AJNR Am J Neuroradiol 2021; 42:1109-1115. [PMID: 33707282 PMCID: PMC8191671 DOI: 10.3174/ajnr.a7066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/11/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE Physician training and onsite proctoring are critical for safely introducing new biomedical devices, a process that has been disrupted by the pandemic. A teleproctoring concept using optical see-through head-mounted displays with a proctor's ability to see and, more important, virtually interact in the operator's visual field is presented. MATERIALS AND METHODS Test conditions were created for simulated proctoring using a bifurcation aneurysm flow model for WEB device deployment. The operator in the angiography suite wore a Magic Leap-1 optical see-through head-mounted display to livestream his or her FOV to a proctor's computer in an adjacent building. A Web-based application (Spatial) was used for the proctor to virtually interact in the operator's visual space. Tested elements included the quality of the livestream, communication, and the proctor's ability to interact in the operator's environment using mixed reality. A hotspot and a Wi-Fi-based network were tested. RESULTS The operator successfully livestreamed the angiography room environment and his FOV of the monitor to the remotely located proctor. The proctor communicated and guided the operator through the procedure over the optical see-through head-mounted displays, a process that was repeated several times. The proctor used mixed reality and virtual space sharing to successfully project images, annotations, and data in the operator's FOV for highlighting any device or procedural aspects. The livestream latency was 0.71 (SD, 0.03) seconds for Wi-Fi and 0.86 (SD, 0.3) seconds for the hotspot (P = .02). The livestream quality was subjectively better over the Wi-Fi. CONCLUSIONS New technologies using head-mounted displays and virtual space sharing could offer solutions applicable to remote proctoring in the neurointerventional space.
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Affiliation(s)
- A T Rai
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - G Deib
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
| | - D Smith
- West Virginia University Reed College of Media (D.S.), Morgantown, West Virginia
| | - S Boo
- From the Department of Interventional Neuroradiology (A.T.R., G.D., S.B.), Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, West Virginia
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Applications of Smart Glasses in Applied Sciences: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11114956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to review academic papers on the applications of smart glasses. Among 82 surveyed papers, 57 were selected through filtering. The papers were published from January 2014 to October 2020. Four research questions were set up using the systematic review method, and conclusions were drawn focusing on the research trends by year and application fields; product and operating system; sensors depending on the application purpose; and data visualization, processing, and transfer methods. It was found that the most popular commercial smart glass products are Android-based Google products. In addition, smart glasses are most often used in the healthcare field, particularly for clinical and surgical assistance or for assisting mentally or physically disabled persons. For visual data transfer, 90% of the studies conducted used a camera sensor. Smart glasses have mainly been used to visualize data based on augmented reality, in contrast with the use of mixed reality. The results of this review indicate that research related to smart glasses is steadily increasing, and technological research into the development of smart glasses is being actively conducted.
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Romare C, Skär L. Smart Glasses for Caring Situations in Complex Care Environments: Scoping Review. JMIR Mhealth Uhealth 2020; 8:e16055. [PMID: 32310144 PMCID: PMC7199139 DOI: 10.2196/16055] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/27/2019] [Accepted: 02/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background Anesthesia departments and intensive care units represent two advanced, high-tech, and complex care environments. Health care in those environments involves different types of technology to provide safe, high-quality care. Smart glasses have previously been used in different health care settings and have been suggested to assist health care professionals in numerous areas. However, smart glasses in the complex contexts of anesthesia care and intensive care are new and innovative. An overview of existing research related to these contexts is needed before implementing smart glasses into complex care environments. Objective The aim of this study was to highlight potential benefits and limitations with health care professionals' use of smart glasses in situations occurring in complex care environments. Methods A scoping review with six steps was conducted to fulfill the objective. Database searches were conducted in PubMed and Scopus; original articles about health care professionals’ use of smart glasses in complex care environments and/or situations occurring in those environments were included. The searches yielded a total of 20 articles that were included in the review. Results Three categories were created during the qualitative content analysis: (1) smart glasses as a versatile tool that offers opportunities and challenges, (2) smart glasses entail positive and negative impacts on health care professionals, and (3) smart glasses' quality of use provides facilities and leaves room for improvement. Smart glasses were found to be both a helpful tool and a hindrance in caring situations that might occur in complex care environments. This review provides an increased understanding about different situations where smart glasses might be used by health care professionals in clinical practice in anesthesia care and intensive care; however, research about smart glasses in clinical complex care environments is limited. Conclusions Thoughtful implementation and improved hardware are needed to meet health care professionals’ needs. New technology brings challenges; more research is required to elucidate how smart glasses affect patient safety, health care professionals, and quality of care in complex care environments.
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Affiliation(s)
- Charlotte Romare
- Region Blekinge, Karlskrona, Sweden.,Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
| | - Lisa Skär
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
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Carrera JF. A Systematic Review of the Use of Google Glass in Graduate Medical Education. J Grad Med Educ 2019; 11:637-648. [PMID: 31871562 PMCID: PMC6919184 DOI: 10.4300/jgme-d-19-00148.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/13/2019] [Accepted: 08/21/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Graduate medical education (GME) has emphasized the assessment of trainee competencies and milestones; however, sufficient in-person assessment is often constrained. Using mobile hands-free devices, such as Google Glass (GG) for telemedicine, allows for remote supervision, education, and assessment of residents. OBJECTIVE We reviewed available literature on the use of GG in GME in the clinical learning environment, its use for resident supervision and education, and its clinical utility and technical limitations. METHODS We conducted a systematic review in accordance with 2009 PRISMA guidelines. Applicable studies were identified through a review of PubMed, MEDLINE, and Web of Science databases for articles published from January 2013 to August 2018. Two reviewers independently screened titles, abstracts, and full-text articles that reported using GG in GME and assessed the quality of the studies. A systematic review of these studies appraised the literature for descriptions of its utility in GME. RESULTS Following our search and review process, 37 studies were included. The majority evaluated GG in surgical specialties (n = 23) for the purpose of surgical/procedural skills training or supervision. GG was predominantly used for video teleconferencing, and photo and video capture. Highlighted positive aspects of GG use included point-of-view broadcasting and capacity for 2-way communication. Most studies cited drawbacks that included suboptimal battery life and HIPAA concerns. CONCLUSIONS GG shows some promise as a device capable of enhancing GME. Studies evaluating GG in GME are limited by small sample sizes and few quantitative data. Overall experience with use of GG in GME is generally positive.
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Bertolo R, Hung A, Porpiglia F, Bove P, Schleicher M, Dasgupta P. Systematic review of augmented reality in urological interventions: the evidences of an impact on surgical outcomes are yet to come. World J Urol 2019; 38:2167-2176. [PMID: 30826888 DOI: 10.1007/s00345-019-02711-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/26/2019] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To perform a systematic literature review on the clinical impact of augmented reality (AR) for urological interventions. METHODS As of June 21, 2018, systematic literature review was performed via Medline, Embase and Cochrane databases in accordance with the PRISMA guidelines and registered at PROSPERO (CRD42018102194). Only full text articles in English were included, without time restrictions. Articles were considered if they reported on the use of AR during urological intervention and the impact on the surgical outcomes. The risk of bias and the quality of each study included were independently assessed using the standard Cochrane Collaboration risk of bias tool and the Risk Of Bias In Non-randomised Studies-of Interventions Tool (ROBINS-I). RESULTS 131 articles were identified. 102 remained after duplicate removal and were critically reviewed for evidence synthesis. 20 studies reporting on the outcomes of the use of AR during urological interventions in a clinical setting were considered. Given the mostly non-comparative design of the studies identified, the evidence synthesis was performed in a descriptive and narrative manner. Only one comparative study was found, with the remaining 19 items being single-arm observational studies. Based on the existing evidence, we are unable to state that AR improves the outcomes of urological interventions. The major limitation of AR-assisted surgery is inaccuracy in registration, translating into a poor navigation precision. CONCLUSIONS To date, there is limited evidence showing superior therapeutic benefits of AR-guided surgery when compared with the conventional surgical approach to the respective disease.
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Affiliation(s)
- Riccardo Bertolo
- Glickman Urological and Kidney Institute, Cleveland Clinic, 2050 E 96th St, Q Building, Cleveland, OH, 44195, USA. .,Urology Department, "San Carlo di Nancy" Hospital, Rome, Italy.
| | - Andrew Hung
- Center for Robotic Simulation and Education, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Pierluigi Bove
- Urology Department, "San Carlo di Nancy" Hospital, Rome, Italy
| | - Mary Schleicher
- Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland, OH, USA
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McCullough MC, Kulber L, Sammons P, Santos P, Kulber DA. Google Glass for Remote Surgical Tele-proctoring in Low- and Middle-income Countries: A Feasibility Study from Mozambique. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1999. [PMID: 30656104 PMCID: PMC6326622 DOI: 10.1097/gox.0000000000001999] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/14/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Untreated surgical conditions account for one-third of the total global burden of disease, and a lack of trained providers is a significant contributor to the paucity of surgical care in low- and middle-income countries (LMICs). Wearable technology with real-time tele-proctoring has been demonstrated in high-resource settings to be an innovative method of advancing surgical education and connecting providers, but application to LMICs has not been well-described. METHODS Google Glass with live-stream capability was utilized to facilitate tele-proctoring between a surgeon in Mozambique and a reconstructive surgeon in the United States over a 6-month period. At the completion of the pilot period, a survey was administered regarding the acceptability of the image quality as well as the overall educational benefit of the technology in different surgical contexts. RESULTS Twelve surgical procedures were remotely proctored using the technology. No complications were experienced in any patients. Both participants reported moderate visual impairment due to image distortion and light over-exposure. Video-stream latency and connection disruption were also cited as limitations. Overall, both participants reported that the technology was highly useful as training tool in both the intraoperative and perioperative setting. CONCLUSIONS Our experience in Mozambique demonstrates the feasibility of wearable technology to enhance the reach and availability of specialty surgical training in LMICs. Despite shortcomings in the technology and logistical challenges inherent to international collaborations, this educational model holds promise for connecting surgeons across the globe and introducing expanded access to education and mentorship in areas with limited opportunities for surgical trainees.
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Affiliation(s)
- Meghan C McCullough
- Division of Plastic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | | | - Patrick Sammons
- Division of Plastic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
| | - Pedro Santos
- Department of Surgery, Matola Hospital, Matola, Mozambique
| | - David A Kulber
- Division of Plastic Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, Calif
- Department of Plastic and Reconstructive Surgery, Cedars Sinai Hospital, Los Angeles, Calif
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Vision for the future on urolithiasis: research, management, education and training—some personal views. Urolithiasis 2018; 47:401-413. [DOI: 10.1007/s00240-018-1086-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022]
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