RESUMO
Introduction: The SARS-CoV-2 pandemic has affected global public healthcare for several years. Numerous medical professionals have been infected since the outbreak in 2019, resulting in a shortage of healthcare providers. Since traditional personal protective wear was insufficient to eliminate the virus transmission reliably, new strategies to avoid cross-infection were imperative while enabling high-quality medical care. In the project ProteCT, we investigated the potential of robotic-assisted examination in providing medical examination via a telemedical approach. Material and Methods: We constructed a fully functional examination cabin equipped with cameras, microphones, screens and robotic arms to evaluate usability and perception. Therefore, we conducted a preliminary study with 10 healthy volunteers and 10 physicians to gain first insights and optimize the setup. In a second step, we performed telemedical examinations of actual patients from the local emergency department to compare the robotic approach with the classical method of measuring vital signs, auscultation, palpation and percussion. Results: The preliminary study identified basic requirements, such as the need for force-feedback and telemedical training for physicians. In the main study, acceptance was high and most patients indicated they would use a telemedical system again. Our setup enabled the physician to make the same diagnoses as by classic examination in the emergency department in most cases. Discussion: The potential acceptance of a telemedical system such as ProteCT is high. Robotic telemedical approaches could complement future healthcare beyond the Corona pandemic to reach rural areas or even war zones. Moreover, the daily clinical use of robotic telemedicine could improve patients' safety, the quality of perioperative management and the workflow in any medical facility. Conclusion: The development of telemedical and telerobotic systems is a multidisciplinary and complex challenge. However, acceptance of the proposed system was high among patients and physicians, indicating the potential use of similar systems for future healthcare.
RESUMO
The current crisis surrounding the COVID-19 pandemic demonstrates the amount of responsibility and the workload on our healthcare system and, above all, on the medical staff around the world. In this work, we propose a promising approach to overcome this problem using robot-assisted telediagnostics, which allows medical experts to examine patients from distance. The designed telediagnostic system consists of two robotic arms. Each robot is located at the doctor and patient sites. Such a system enables the doctor to have a direct conversation via telepresence and to examine patients through robot-assisted inspection (guided tactile and audiovisual contact). The proposed bilateral teleoperation system is redundant in terms of teleoperation control algorithms and visual feedback. Specifically, we implemented two main control modes: joint-based and displacement-based teleoperation. The joint-based mode was implemented due to its high transparency and ease of mapping between Leader and Follower whereas the displacement-based is highly flexible in terms of relative pose mapping and null-space control. Tracking tests between Leader and Follower were conducted on our system using both wired and wireless connections. Moreover, our system was tested by seven medical doctors in two experiments. User studies demonstrated the system's usability and it was successfully validated by the medical experts.
RESUMO
Apart from the tremendous increase in the demand for telemedicine during the COVID-19 pandemic, the use of telemedical technology offers many advantages, such as better coverage of rural areas and improved access to specialists. While current telediagnostic possibilities are often limited to a verbal consultation, the field of surgery has already made use of robotics for one of the most challenging areas of medicine: invasive procedures. Since comprehensive diagnostics are a prerequisite for each surgery, we built upon the knowledge gained in telesurgery and developed a telediagnostic system that allows for an extensive perioperative and emergency examination. It is based on a robotic platform consisting of a remote lead robotic arm at the physician's site and a follower robot at the patient's site. Mirroring all movements directly and using force-feedback, both parties can precisely interact, enabling tasks such as auscultation, percussion, and palpation without the need for extensive training. Our overall setup also includes the possibility to measure and monitor all relevant vital parameters and can be used to perform ear and nasopharyngeal inspections as well as an automatic swab to screen for COVID or other contagious diseases prior to hospital admission. In this paper, we focus on the potential of this technology for the surgical community by demonstrating the ease of adding an ultrasound probe to our modular setup to perform a high-quality emergency ultrasound examination. While the system is not yet ready for everyday use in a hospital and drawbacks such as a high cost persist, our setup paves the way for the future use of telediagnostics in surgery.
