Region-of-interest video coding for enabling surgical telementoring in low-bandwidth scenarios

Surgical telementoring can prove very effective in a military surgical paradigm where less experienced surgeons deployed at forward sites can be mentored by more experienced specialists from a rearward remote site, thus enhancing in-theater surgical options by bringing scarce expertise into play. However, lack of sufficient bandwidth in active military theaters limit the ability to implement real-time video communication capability, and hence render such clinically beneficial programs undeliverable. Region-of-interest (ROI) video-coding presents a possible solution to this problem. By allocating more bits to the ROI as compared to the rest of the frame (also known as background (BG)), ROI encoding of surgical videos can increase the bandwidth perceived by the telementoring application. In this paper, we introduce a flexible and interactive ROI in a low-complexity, H.264-compliant and diagnostically lossless (DL) fashion to enable remote mentoring of surgical procedures in very low-bandwidth scenarios. Further, subjective evaluations by surgeons indicate that ROI-encoded videos are preferred over the uniformly-encoded videos for the purpose of surgical evaluation and telementoring.