The Operating Theatre Journal - Flipbook - Page 28
Digitalisation in the operating theatre
Full attention on the patient: Multi Display Manager transmits, combines and manages up to 27 image sources in real time
with minimal latency on 4K UHD
Dynamic layout control via tablet, on-screen and remote control via API
The Multi Display Manager (MDM) is a fully integrated solution that supports the smooth running
of complex and intricate surgeries. This is also very necessary, because as medical technology
constantly develops, more and more image and video signals are finding their way into the
operating theatre. Physicians and surgical teams have to assimilate a lot of visual information,
often on many screens at different locations in the operating theatre. Attention, which ideally
should always be on the patient, is deflected to monitoring and managing the technology. Tritec
Electronic GmbH put an end to this for the first time in 2008 with its MDM. 2023 will now see
MDM’s 5th generation available on the market: the system captures and transmits up to 27
image sources almost latency-free on up to six 8 MP displays (4K) or other screen combinations
and additional IP streams. Each source can be dynamically scaled, moved and managed in the
process. It can be controlled either directly from the operating theatre via touch panel/tablet or
keyboard and mouse, or via the IP network interface from a control system.
TRITEC control room
The system is quick and easy to use, even
with changing operating theatre set-ups.
All Images courtesy of : TRITEC Electronic
“Medical staff need to monitor numerous digital information sources in parallel during a surgery
and evaluate them in real time,” says Markus Müller-Heidelberg, Managing Director of Tritec
Electronic GmbH. These sources are transmitted by medical imaging systems that fulfil a wide
range of functions, from monitoring vital signs and interventional imaging to robots that assist in
surgical tasks. Until now, it has been common practice for the operating theatre to be equipped
with a separate screen for each of these devices. However, not only can it become easy to
lose sight of the overview when monitoring and managing all of them rapidly; it can also tie up
a significant proportion of the resources during a surgery. “Our Multi Display Manager (MDM)
integrates all these sources – up to 27 in total – into a single central administration point,”
Müller-Heidelberg explains. “The signals that are output by the MDM can then be clearly used
and managed on up to six independent displays.”
4K inputs on up to six independent 4K displays
The manufacturer has developed a new input card for the current product version that feeds
several image signals of different formats such as DisplayPort, HDMI and SDI directly into the unit
via fibre-optic Ethernet. This means the application is no longer restricted by the limitations of
copper cables. The signals can be output on up to six connections with a maximum of 8 MP (4K)
at 60 Hz. Several screens of the same resolution can be combined as extended monitors to form
large displays.
“The biggest problem in development is the bandwidth limit of the PCIe,” Müller-Heidelberg
says. “This is because we route the image data natively via the local bus system to achieve
real-time processing with minimal latencies of just one to three frames, which is so critical in
medical technology for hand-eye coordination.” Because delays in data transmission can have
fatal consequences in the operating theatre. To ensure that the MDM functions seamlessly in
such critical application environments under 24/7 continuous operation, not only is the hardware
robustly constructed, but it is also equipped with redundant power supply and Active Watch
Dog. Due to the variable form factor from 19” to 2 or 4U, the system can be easily installed
even in small spaces, as is often necessary in older operating theatres. The manufacturer puts
significant attention into responding agilely to requests in terms of dimensions and function from
the environment of OEM providers of total OP solutions and integrators, and to implementing
them in an application-specific manner.
The MDM captures and transmits up to 27
video inputs practically latency-free to a
maximum of six 8 MP displays (4K UHD) or
other screen combinations with a total of
up to five displays and additional streams.
Individually definable personalised layouts and live streams
The image data is routed natively over the local bus system
to achieve real-time processing with minimal latencies of
only one to three frames.
The MDM standard mode provides predefined layouts which display the
individual image sources with minimal effort. This means that the system
is ready for use quickly and easily, even with changing operating theatre
set-ups. In contrast, the flexible KVM mode means four independent users
can operate up to 14 sources. This is particularly useful for more intricate
and lengthy surgeries with larger teams. The MDM also enables a clearer
setup in the control room by consolidating the displays from various systems.
“Different layouts including extended or mirrored displays can be defined for
each output, and the data sources can also be cropped or overlap each other
– or be protected against this,” explains Müller-Heidelberg.
“You are not restricted to choosing between the classic four- or six-image split.” This flexibility streamlines the workflow and helps surgical
teams focus. Control is possible via different interfaces depending on the degree of system integration and individual process preferences. The
manufacturer provides a web application and a REST API for remote administration.
The MDM is IP-capable as standard, so that local outputs and inputs as well as streams can be integrated – both as inputs and outputs. This opens
up new possibilities for research and teaching in particular, as operating theatres can be streamed live into the lecture theatre. Alternatively,
the technology means other specialists can be consulted, so that the operating surgeon can, for example, get an assessment from a colleague
who is not on site but who is following the corresponding sources live. “Our MDM offers surgical teams the tool they need to keep track of the
available image and video sources even in complex and lengthy surgeries, allowing them to devote their full attention to patient care,” says MüllerHeidelberg in summary.
Further information is at www.multi-display-manager.com and www.tritec.de
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