Live surgery from Japan to South Africa: High-quality image transmission over a high-speed academic network

  • Shuji Shimizu Kyushu University Hospital
  • Sandie Thomson
  • Gregory Doyle
  • Sinethemba Mandyoli
  • Nobuhiro Torata
  • Takashi Ueki
  • Yasuichi Kitamura
  • Cao Duc Minh
  • Yasuaki Antoku
  • Koji Okamura
  • Naoki Nakashima
  • Masao Tanaka
Keywords: research and education network, digital video transport system, live surgery, remote medical education, South Africa


Quality preservation during the transmission of
medical moving images is challenging owing to image compression in the
limited bandwidth of the Internet. Satellite transmission does not
solve this problem because of the high cost involved, hindering the
advancement of practical telemedicine. We developed a
new, affordable and usable system, and applied it to the live
transmission of surgery from Japan to South Africa. The digital video
transport system (DVTS), which is free software that transforms digital
video signals directly to Internet Protocol, and academic networks
dedicated to research and education purposes were used with bandwidth
of 30 Mbps. The cipher program IPsec was used to protect patient
privacy. Laparoscopic rectal surgery was transmitted live from Kyushu
University Hospital in Japan, to the University of Cape Town in South
Africa, as well as Cho Ray Hospital in Vietnam, over a period of 2
hours. Interactive discussion was held among the three sites with the
transmission of clear, high-resolution, and smooth surgical images.
This project is an important milestone achieved in South Africa
indicating its feasibility for developing nations with National
Research and Education Networks and provides a base for its domestic
and international expansion.

Author Biography

Shuji Shimizu, Kyushu University Hospital


Telemedicine Development Center of Asia


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How to Cite
Shimizu, S., Thomson, S., Doyle, G., Mandyoli, S., Torata, N., Ueki, T., Kitamura, Y., Minh, C. D., Antoku, Y., Okamura, K., Nakashima, N., & Tanaka, M. (2013). Live surgery from Japan to South Africa: High-quality image transmission over a high-speed academic network. Journal of the International Society for Telemedicine and EHealth, 1(3), 80-85. Retrieved from
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