Realtime tele-operated abdominal and fetal echography in 4 medical centres, from one expert center, using a robotic arm & ISDN or satellite link

The objective of this paper is to design and validate a method for tele-operating (from an expert site) an echographic examination in an isolated site where the patient stays. A dedicated robotic arm (ESTELE) holding a real ultrasound probe is remotely controlled from the expert site with a fictive probe, and reproduces on the real probe all the movements of the expert hand. The isolated places, are areas with reduced medical facilities, secondary hospitals 20 to 100 km from the main hospital in Europe, dispensaries in Africa, Amazonia, the a rescue vehicles. ESTELE was tested on 87 adults and 29 pregnant with ISDN or satellite lines. During fetal tele-operated echography the expert was able to perform appropriate views of the fetal structures in 95% of the cases. During exploration of adult abdomen the expert visualized the main organs in 87% of the cases. Presently the ESTELE system is installed in 4 secondary hospitals, 40 to 100 km from our university hospital and tele-operated daily by our staff. Robotized tele-echography provide similar information as direct examination. No false diagnostic was reported. Moreover the patients were examined by an expert from the university hospital while staying in the Medical center proximal to their home.