4K Video Over IP in the Operating Room: Fibre, Network and Routing Basics

Baseband versus IP video routing

Baseband routing, using SDI or HDMI, sends each video signal over dedicated copper or fibre links into a matrix router. It is predictable and low-latency, and each source and destination has its own cable. Capacity is fixed by the router's port count, so adding a source or display may mean adding hardware.

IP routing sends video as packets across a managed network. Sources and displays are endpoints, and routes are changed in software, so adding a camera or screen can be as simple as connecting it to the network and configuring it. The price is a greater dependence on network design: bandwidth, latency, switch quality and security have to be engineered, not assumed.

What the room's video chain really needs

List the sources: endoscopic cameras, room cameras, light cameras, ultrasound, imaging, patient monitors and PACS images. List the destinations: wall and boom monitors, a recording system, teaching displays and outside conference links. Then estimate the number of simultaneous streams and the resolution of each. Not every source needs 4K, but the primary surgical image often does.

Decide whether the video must be uncompressed, lightly compressed or compressed. Uncompressed 4K needs far more bandwidth than a compressed stream, and the right choice depends on clinical use and the distance travelled. Lojer's OpenOR is described with a fibre network that supports uncompressed 4K, plus telementoring between the OR and an outside audience, which gives a reference point for the capacity you should plan for.

• Count simultaneous sources, destinations and recordings
• Set resolution and latency needs per source, with the main surgical image first
• Decide on compression policy and what leaves the room
• Plan for growth: additional sources and displays over the room's life

Fibre cabling and containment

Whatever protocol is chosen, fibre cabling is the long-lived part of the infrastructure. Run it in dedicated containment with enough spare capacity, pulling extra strands during construction when it is cheap. Include routes to ceiling pendants and suspended monitors, since these are the usual endpoints; see surgical monitor ceiling mount for the mechanical side.

Specify connector types, minimum bend radii and labelling. Test and document every link after installation. In many projects cabling is installed by the main contractor, while the video integrator provides terminations and testing, so write the responsibility into the contract.

Network requirements for an integrated OR

An operating room network should be segregated from the general hospital network, with managed switches, quality-of-service control and redundancy where clinical use demands it. Define the uplink to the hospital core, security policy for devices, time synchronisation and monitoring. Integration systems such as OpenOR communicate with HIS, BMS and PACS, so the connection points and responsibilities for those interfaces must be agreed with hospital IT early. For connecting patient records and imaging, see HIS and PACS connectivity.

Involve IT security from the start. Medical devices on the network may have constraints on patching and scanning, so the design must account for them. Document IP addressing, VLANs and access control as part of the handover.

Choosing and validating the design

Ask integrators to show a block diagram of the video chain with bandwidth figures, a list of the network equipment, and a test plan covering latency, picture quality and failover. Ask what happens if a switch or fibre link fails during a case, and how the system is monitored.

Pilot, if possible, with the real sources before approving the full design. Beckfinity can help you scope an integrated room with Lojer OpenOR and coordinate supply and installation. Contact our specialists to discuss your OR video infrastructure and request a quote.