# Rebirth of Distributed AI--A Review of eHealth Research
## 8 Selected IoMT-Based Health Applications
### Tele-Surgery or Autonomous Surgery
Such technology cannot be more wanted and relevant than it is today with the current situation of COVID-19, where people's mobility is restricted, air flights are banned, and limited interaction is advised. Imagine what telesurgery can offer in such scenarios. For example, telesurgery can enable three geographically separated surgeons to operate on the same patient, who might also be in a fourth location. A virtual operating theater can bring the surgeons, the patient, and the medical staff all together. The virtual room would display the patient's vital signs on its virtual walls, as well as other critical physiological data. In the middle, a holographic image of the organ or field that's undergoing the surgery would be reflected for all. Such technology would enable surgeons to communicate and perform with more accuracy and precision due to the comprehensive and high-fidelity display of the holograms. In the real operation room, where the patient is located, a robotic surgeon acts as per the surgeons' commands. These commands would be triggered using gloves worn by the surgeons. A glove would translate the motions of a surgeon's fingers into commands for the robotic surgeon to follow, and the glove would also transmit real-time sensing for the surgeons. This feedback, transmitted by the gloves back to the surgeons, would enable them to actually sense the feel of tissues, blood, and organs. Ref. [46] explains telesurgery as depicted in Figure 11. A tele surgical system will consist of a master console and a slave robot, i.e., a teleoperator. A master console is an interface that is used by the real surgeon and is composed of a haptic device for position-orientation input, a video display and headphones for video and voice feedback and in the future, it will have haptic feedback output. On the other end point, the valve robot, the teleoperator is equipped with a 3D video camera and a microphone and will have several force sensors and tactile sensors available in the future. So, telesurgery will rely on two major technologies:  
* visual display (3D high-definition video or holographic objects) of the surgical field
* haptic feedback technology to translate the real surgeon's control movements into commands to operate the on-site robotic surgeon. Holography provides better communication for surgeons due to the extensive visualization of a patient's body using high resolution. It helps surgeons to examine different body parts like the liver, brain, skeleton, heart, lungs, nerves, vascular system, and muscles. Holography can digitally store patient data and provide a massive amount of detailed information [51]. On the other hand, haptic devices are used to send and receive real-time physical sensation data. This helps doctors to feel real-time sensations remotely. They convert the human input to the tactile input using tactile coding [49]. Another promising technology to be added to the two for even a better experience is Augmented Reality and Virtual Reality AR/VR. AR provides a customized depth that can enable the doctor to visually zoom inside the displayed object, e.g., liver, heart, or bone. On the other hand, VR helps in creating one's own artificial environment, as we suggested in the scenario of the three geographically separated surgeons. Because telesurgery will deal with different data  
Figure 11: Feedback loop in telesurgery. formats such as video, audio, physiological data, or haptic feedback, each has different requirements in terms of latency, data rate, and packet loss. As per [47], less than 200 ms end-to-end latency is acceptable for non-haptic telesurgery. This end-to-end latency requirement gets dramatically less for haptic-telesurgery. As per [48], the minimum latency requirements for haptic data, 3D video, and vital signs would be as presented in Table 6.  
We summarize the non-negotiable communication requirements for telesurgery as follows:  
* Ultra-low latency: because telesurgery is beneficial over long distances, the greatest challenge to implement it is the latency.