Telemedicine is becoming a practical technology for clinicians across the globe.
With the ever-increasing population, there is an increasing need for more and more physicians. When this comes to radiodiagnosis, there’s a dearth of radiologists worldwide. It is because of the limited resources and complex funding challenges. In India, 80% of the 10000 practicing radiologists are in urban areas. Rural areas and remotely located areas do not even have any well-trained sonographers. Non-availability of radiologists means no or delay in diagnostic imaging which ultimately delays the initiation of treatment and leads to poor disease outcomes.
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And when it comes to obstetrics and gynecology, ultrasound is the first choice of diagnostic imaging as there is no risk of radiation to the growing baby and can help diagnose almost all problems without the need for any invasive procedure. In gynecological practice, imaging methods are usually done to confirm or exclude a diagnosis suspected on the basis of the history and clinical examination of the patient. Ultrasound is needed for the diagnosis of abnormal uterine bleeding, adnexal masses, infertility, pelvic pain, early pregnancy, and many other conditions.
According to studies, approximately 800+ women die from preventable causes related to pregnancy and childbirth. About 25 mn births happen in India every year but, only 24% of them undergo at least one ultrasound scan during the course of the pregnancy, which is one of the major reasons for India having the highest number of birth defects in the world.
This is where Teleoperated robotic arm comes into play. It can solve the whole problem of radiologists' scarcity.
How does a Teleoperated robotic arm work?
The whole system can be divided into 3 major segments
Expert's Station
The radiologist sits at the expert's station where he has ultrasound control and probes for controlling and manipulating the robotic arm which he can see on the display screen as projected by the camera feed from the patient's side in real-time. He also has access to the ultrasound imaging displayed on the other display screen. This allows the radiologist to change the ultrasound settings as per the requirement to get the needed imaging meanwhile he will be getting direct feedback from the patient through live video conferencing.
Patient's Station
Communication
What are the benefits of the teleoperated robotic arm?
Benefits to the patient
● Easy and quick access to imaging procedures
● Improved patient care
● Faster emergency examination
● Instant result with a live diagnosis of the condition
● Access to consultation in real-time via video conferencing
● Timely re-evaluation if needed
● Saves traveling time and cost
Benefits to the radiologists
Benefits to the healthcare facility
Accuracy of the diagnosis
There are many studies done in this regard and according to them the accuracy of diagnosis by the robot is similar to that of the conventional echography on the patient.
One such study done on 105 patients showed that about 89% of the robotic arm provided the same results as the conventional method.
Reducing the morbidity and mortality of pregnant women
By making ultrasound imaging accessible to everyone, Teleoperated robotic arm can significantly reduce morbidity and mortality in pregnant conditions.
The majority of first and second-trimester mortality is because of the
- Ectopic pregnancy
- Abortion or miscarriage
- Gestational trophoblastic diseases
- Disease of the Placenta
Many a time, women are not aware that they are pregnant and present to the hospital with pelvic pain or abnormal bleeding which occurs because of any of the above-mentioned conditions. This can be easily prevented by early diagnosis. So, it is important to perform ultrasound on all women with amenorrhea to rule out early pregnancy complications or abortion, or ectopic pregnancy.
Ultrasound for better fetal outcomes
Not only the maternal health conditions, but Ultrasound can also help diagnose various conditions of the growing baby and can help to start early intervention if needed in order to deliver a healthy child.
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The mortality rate in twin pregnancy is 5 times higher than in singleton pregnancy with a higher incidence in monochorionic (5%) than dichorionic (2%) twin pregnancies.
Late first-trimester ultrasound, also commonly known as NT Scan ( Nuchal Translucency) which measures the fluid collection between skin and spine of the growing baby, commonly done at 11 to 15 weeks, helps in a diagnosis of chromosomal anomalies in the fetus like Down Syndrome.
Other detectable conditions of a growing baby include Acrania, Anencephaly, Encephalocele, Gastroschisis, Cleft palate, and more.
Once an anomaly is detected, Medical termination of pregnancy(MTP) can be done.MTP in early pregnancy is associated with fewer complications in the mother.
There is no doubt that Teleoperated robotic arm is a blessing when it comes to Obstetrics and Gynecology.
References
Margaret E Kruk, Anna D Gage, Naima T Joseph, Goodarz Danaei, Sebastián García-Saisó, Prof Joshua A Salomon, Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries, 2018 [Link]
F Y Chan et al. J Telemed Telecare, Minimum requirements for remote realtime fetal tele-ultrasound consultation, 1999. [PubMed]
P. Arbeille, J. Ruiz, M. Chevillot,F. Perrotin, P. H. Hervé, P. Vieyres, G. Poisson, Teleoperated robotic arm for echographic diagnosis in obstetrics and gynecology,2004 [Link]
SebireN. J.SnijdersR. J. M.HughesK.Sepulveda W. NicolaidesK. H.1997 The hidden mortality of monochorionic twin pregnancies. BJOG 10412031207 [PubMed]
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