In the context of image guided surgery, two operators are directly contributing to the procedure:

In some situations, both operators cannot stand on the same side of the patient. Because the control image has to be in front of each operator, two monitors are required, a primary one, directly connected to the imaging system, and the second one on the other side of the patient.

Additional operators (e.g., surgery nurse) might also have to see what is happening on additional monitors in order to anticipate actions (e.g., providing instrument).

The live video image has to be transferred to additional monitors with a minimal latency, without modifying the image itself (resolution…). The latency between the two monitors (see Figure PPPP.2-1) should be compatible with collaborative activity for surgery where the surgeon is, for example, operating based on the primary monitor and the assistant is controlling the endoscope based on the second monitor. All equipment is synchronized with the Grand Master. The DICOM-RTV generation capability might be either an integrated part of the laparoscope product, or the laparoscope might send an HD video signal to the DICOM-RTV generator (Video-to-DICOM converter on the Figure PPPP.2-1). It is important that the converter be able to send video with or without a metadata overlay to the assistant monitor. This supplement addresses only the communication aspects, not the presentation.