At the end of April, the University Hospital Center (CHU) of Rennes carried out an unprecedented experiment: simulating wireless heart surgery in 5G. It is part of the European 5G-TOURS research project, linked to the European Horizon 2020 program. Associated with the project are Rennes-based assisted reality company Ama, B-com, the Institute for Technology Research, Nokia, Orange and Philips. In a real situation, the goal would be to be able to relay the intervention in real time and use augmented reality when setting up the operating room so that the cables do not interfere with the surgeons,
In particular, cardiologist Ervan Donal performed a minimally invasive intervention on the heart of a “phantom” patient. This was a procedure to protect the heart from a potential recurrence of a stroke when it is associated with an open foramen (residual communication between the left atrium and right atrium of the heart).
This operation was facilitated by an overlay of ultrasound images and x-rays transmitted over 5G at 26 GHz through an augmented reality app. “We chose this band for bandwidth reasons,” explains Mathieu Lagrange, director of the Network and Security Lab at B-com. This use case requires very high upstream and downstream speeds.” Since it is not available on public network frequencies, the use of this capacity has been the subject of a license application to the Regulatory Authority for Electronic Communications, Posts and Press Distribution (Arcep).
The whole purpose of this experiment was to get perfect image synchronization to improve the efficiency of medical care. Indeed, the delay in time can cause a delay in the space of the doctor’s gesture. “The images were transmitted by the equipment in the operating room via a 5G network and then combined, that is, we superimposed on the X-ray scanner the images obtained by the ultrasonic sensor,” says Mathieu Lagrange.
The operation is controlled remotely
5G also allowed Alexandros Stefanidis, a cardiac surgeon in Athens, Greece, to monitor the progress of the operation remotely. The images were captured using connected glasses equipped with a camera developed by Ama. “We checked the quality of the images recovered in Athens. They are exactly the same as those recorded in the room,” said Nelly Besnard, head of research and innovation at Rennes University Hospital.
Overall, “reviews about this experiment are positive,” she adds. Several parameters could be checked. First of all, the harmlessness of waves for patients and practitioners. The measurements were entrusted to a specialized company under the supervision of the National Frequency Agency (ANFR). “The results are very encouraging, even below the simulations done,” notes Nelly Besnard. A public report presenting these results should be published within a few weeks so that it can serve as a guide for future 5G experiments.
Computer security is also optimal, she concludes. “The spectrum in the millimeter range is suitable for this use case because the signals [renvoyés par les équipements] have a much lower penetrating power than in the low frequency ranges,” explains Mathieu Lagrange. Result: “Signal reception outside the operating room is not possible.”
Adjustments to be made
Since this is an experiment, adjustments still need to be made. “Image quality and aspects of augmented reality applications need to be improved,” explains Nelly Besnard. Another issue is the obligation to use routers, “Customer Premises Equipment” (CPE), to connect medical devices (ultrasound sensor, screens, etc.) to the network, which requires wires. “The next step is to remove these routers and replace them with chips or some kind of dongle built into the devices themselves. Equipment manufacturers should take care of this,” she adds.
Rennes University Hospital has already carried out a 5G experiment in a connected ambulance in September 2021. Emergency physician Tariq Sherfawi conducted an ultrasound examination of the heart of a “phantom” patient there, remotely supervised by the university hospital teams. Cardiologist Erwan Donal had real-time images transmitted by the ambulance’s ultrasound scanner thanks to a video feed from the connected goggles the ambulance doctor was equipped with. In this way, he was able to tell him the orientation of the probe and help him interpret the results.
A new experiment is already emerging, says Nellie Besnard. In a few months, with funding from the France Relance plan, a case study on the use of resuscitation will be launched. Inspired by the health situation, “the goal will be to be able to roll out the resuscitation service from the classic help desk in 24 hours thanks to the deployment of a private 5G network,” she explains. It remains to be seen whether this new project will live up to expectations. One thing is certain: 5G will change the healthcare sector.