iPhone users

It just came to my attention that a large number of users have iPhone instead of an Android phone.

While I recommend using an Android phone (as I have personal experience of them), I understand that people may have invested (far too much) money into iPhones.

Thus, when I get hold of an iPhone, I will write an equivalent tutorial on how to connect one to a PC.

Perhaps readers of this tutorial could donate an iPhone to me? Afterwards I would give it to my mum; after all, I do owe her something for the basket I borrowed.

Setting up (software)

I shall not detail how to set up the required PC programmes and smartphone App, as they should be self-explanatory. However, I will give one word of advice: charge your smartphone to 100% because the combination of both using the camera and LED and transmitting data over wireless network will rapidly drain the battery!

Connect both your smartphone and PC to your wireless network.

Begin by starting IP Webcam. You should reach a screen such as:

IP Webcam start screen.

I suggest you use the following settings:

Option	Setting	Comment
Resolution	640×480
Photo resolution	maximum allowable	(only relevant if you will take freeze-frames)
Quality	90	lower this if the output on the PC keeps ‘lagging’.
Orientation	Landscape
FPS Limit	No limit
Focus	Default	This option is important, as later you will be able to auto-focus using your PC.
Prevent going to sleep	Yes

When ready, touch Start Server. This takes the input of your camera and allows a PC to connect to it to see the output.

Press How do I connect? –> I’m using Wi-fi router. Now note down the address it displays; on my network it is 192.168.0.7:8080

You might want to press Actions –> Fade to switch off the smartphone display in order to save battery. As per the previous post, mount the smartphone onto your basket.

On your PC, type the address you noted down earlier into the web browser, e.g. 192.168.0.7:8080. You should see this screen:

Don’t click Open stream in media player just yet (as this option introduces an unacceptable delay between what you do in real life and what you see on screen.) Instead, open VLC, go to Media –> Open Network Stream, and see this screen below:

In the top box, type in http://<address>/video, e.g. on mine it would be http://192.168.0.7:8080/video. Under Caching, set it to about 50 milliseconds. Finally click Play. You should see a screen like this:

Out of focus.

It is out of focus, and dark. No matter; go back to the web browser, click Open remote control panel, which will bring the following screen:

Hit the Turn on LED and Autofocus buttons. Autofocus will focus upon what is at the centre of the field of view.

In VLC it should now look like this:

Well illuminated, in focus.

And there we have it. You should now be able to manipulate the laparoscopic tools in near-real time (a slight delay might be present). In the near future I will try to show some basic skills in a tutorial fashion.

In the next post I will discuss changing the “channel” your wireless router broadcasts on in order to improve performance.

Happy laparoscoping; I hope this will be useful, instructive — and above all — fun!

Setting up (physical)

The concept behind this is to use the basket upside-down with your smartphone being suspended somewhere being used as a video camera. The many holes allow flexibility in your choice of approaches. This post will show how to set up the physical parts. Using the software will be explained in the next post.

After setting up IP Webcam (see next post), suspend the phone from the top of the basket. I used three lengths of suture material:

Laparoscopic grasper demonstrating space for phone.

Smartphone in position to be suspended.

Phone being suspended.

 

Turn the basket + phone upside down, and insert two laparoscopic instruments as required:

Basket with laparoscopic instruments inserted.

Now you have completed the physical setup. You can put any practice equipment underneath the basket.

The next post will detail how to set up the software in order to show what your smartphone camera is detecting on your computer screen.

You will need…

You will need the following items

Android smartphone (I used the fine Samsung Galaxy S3 running Android 4.1.2):

Basket:

Borrowed from mum.

Wireless router. You almost certainly have one if you have broadband internet.

Personal computer. I used the venerable Dell Inspiron 1525; I also have a desktop computer I occasionally use.

Old but reliable.

Laparoscopic tools, e.g. grasper, needle holder, pusher, scissors. Ask your operating theatres if you can borrow these; else your friendly Biomedical Engineering department may lend you discontinued equipment.

Practice equipment e.g. pegs and board. (more ideas and photos will follow in the future.)

You will also need some software.

IP Webcam by Pavel Khlebovich. This Android app was designed to be used to make your phone a security camera whose output could be viewed remotely. However I find it fits our requirements extremely well.

VLC Media Player. You should have this player as your only video player already, such is its awesomeness. I’m using version 2.0.8 Twoflower, but any newer version will be even better, I’m sure.

Web browser, e.g. Mozilla Firefox. (I have version 25.)

The next post will show you how to set up the physical parts. The final post will show you how to set up the software.

Introduction

With the introduction of the European Working Time Directive, additional training time over and above one’s contracted hours are perceived to be necessary in order to achieve proficiency in surgical skills. However opportunities to perform, or even assist, in the operating theatre are competed for by many trainees and restricted due to limited number of operative lists and cases. The situation is aggravated by the small but significant number of consultants who are unsympathetic to the plight of the modern junior doctor and continue to perform procedures themselves instead of delegating them to the trainee.

Thus it falls upon the junior doctor themselves to seek opportunities to gain the skills required for the necessary progression of training. In the spirit of adult/independent learning, I invite anyone interested in performing laparoscopic surgery to try the setup detailed in the following blog posts.

Over the coming months I also hope to upload some tutorial videos to YouTube or other equivalent video sharing site.

I would also like to commend The Clinical Teacher‘s video on how to assemble one’s own laparoscopic practice box. It is the most realistic practice box I have come across, and highly recommend this as an alternative. However I suspect that not every doctor will have easy access to the necessary power tools required for its assembly!

Hence I shall present an alternative setup with (I believe) equipment that is almost universally accessible, and requiring the minimum of effort to set up.

– Dr. Minesh Mistry
FY2 Doctor
United Kingdom.