Live surgery from Japan to South Africa: High-quality image transmission over a high-speed academic network

Quality preservation during the transmission ofmedical moving images is challenging owing to image compression in thelimited bandwidth of the Internet. Satellite transmission does notsolve this problem because of the high cost involved, hindering theadvancement of practical telemedicine. We developed anew, affordable and usable system, and applied it to the livetransmission of surgery from Japan to South Africa. The digital videotransport system (DVTS), which is free software that transforms digitalvideo signals directly to Internet Protocol, and academic networksdedicated to research and education purposes were used with bandwidthof 30 Mbps. The cipher program IPsec was used to protect patientprivacy. Laparoscopic rectal surgery was transmitted live from KyushuUniversity Hospital in Japan, to the University of Cape Town in SouthAfrica, as well as Cho Ray Hospital in Vietnam, over a period of 2hours. Interactive discussion was held among the three sites with thetransmission of clear, high-resolution, and smooth surgical images.This project is an important milestone achieved in South Africaindicating its feasibility for developing nations with NationalResearch and Education Networks and provides a base for its domesticand international expansion