LapGuru is a low cost solution that requires minimal infrastructure to transmit or view the live Laparoscopic surgeries / Endoscopic procedures. The infrastructure requirements are as mentioned below:
Hardware Requirements
A Windows/Mac machine (Desired configuration- Intel i3/ i5 or i7 Processor with 4GB RAM. Machine should have atleast one USB 3.0 port- incase if you need to connect HD grabber)
A Video Grabber Card (VGC) to interface the Laparoscopic / Endoscopic Camera with the computer
You need a VGC to transmit a live surgery. If you are a viewer on LapGuru, you will not need a VGC.
A studio grade microphone to interface the audio (such as Sennheiser)
A unidirectional microphone is needed if a group of people is interacting through a single mic and common speakers.
If you use LapGuru to train a group of surgeons, use a unidirectional microphone to speak. Otherwise, the sound from the speaker interferes with the microphone and echoes your voice.
A broadband Internet connection with a sustained upload speed of 2 Mbps
If the video is getting transmitted at a bandwidth higher than that of viewer’s available bandwidth the viewer may experience jerky or choppy video. Ideally, the viewer needs to have same download speed as that of the uploading speed of the transmitter. You can transmit a SD quality video with a bandwidth of around 500 kbps. For SD+ quality transmission one needs upload speed of 2Mbps, and for HD transmissions, bandwidth of 4Mbps will be required. Higher bandwidth improves the quality of the transmitted video.
To check the speed of your Internet connection, visit http://www.speedtest.net and click Begin Test.
Access to ports 1935 (RTMP) and 554 (RTSP) of the server fms.lapguru.com (IP: 124.153.94.114). (Required if accessing from a corporate environment with firewalls installed, otherwise this step can be ignored)
Software Requirements : Your computer must have
Any of the following operating systems:
Windows VistaTM
Windows 7
Windows XP
Mac OS X Lion version 10.7.4
Any of the following browsers:
Internet Explorer version 9 and later
Mozilla Firefox version 12 and later
Google Chrome version 19 and later
Safari version 4 and later
LapGuru is best viewed in Mozilla Firefox browser.
Adobe® Flash® player version 11 and higher
Adobe® Flash® Media Live Encoder version 3.2 or the latest version available for free on Internet
Flash Media Live Encoder will be needed only for transmitters who are going to transmit the live surgeries. The same is not required for viewers, who are just going to watch the surgery videos.
No. A video grabber card (VGC) is required only if you wish to transmit the video of live surgery. It is basically needed to interface your Laparoscopic / Endoscopic Camera with the computer/laptop.
If you just need to view the surgery transmission, then the grabber card is not required.
The sound from the speaker interferes with the microphone and echoes your voice, thus disturb others. Hence using a separate headphone and microphone is preferred. A studio grade microphone provides the best quality sound.
The latest Laparoscopy / Endoscopy systems have High Definition (HD) digital cameras. However, you need to have high bandwidth Internet connection to transmit a HD quality video.
The S-VIDEO and COMP VIDEO outputs of the CCU provide good and acceptable quality videos which can be viewed even at lower bandwidths. The various output options available in a Medical Grade Laparoscopy / Endoscopy Camera Control unit (CCU) are shown here:
Transmitting analog video using a Video Grabber Card
Use the Video Grabber Card (VGC) to connect your computer to the CCU. Below figure shows a typical VGC. A VGC may consist:
A composite (3 pin connector- red and white for audio and yellow for video) and/or a S-Video port at one end which acts as an input and
A USB Port at the other end which acts as an output. You must connect the USB port to the computer or laptop.
A CCU can be interfaced with the computer either by using the COMP VIDEO (Composite Video) or S-VIDEO outs.
Connecting the computer and CCU using the COMP VIDEO port
Connect the yellow pin (CVBS In) of the VGC to the COMP VIDEO port of the Camera.
Connect the USB of the VGC to the USB of the computer as shown below.
Connecting the computer and CCU using the S-VIDEO port
Connect the black pin (S-Video In) of the VGC to the S-VIDEO port of the Camera.
Connect the USB of the VGC to the USB of the computer.
Transmitting digital video using a firewire cable
To transmit the video digitally, connect the Camera to the computer using a firewire cable. You can use a firewire cable with
6 pins connectors at both ends (input and output) or
4 pins connectors at both ends or
6 pins connector at one end and 4 pins connector at other end
Select the firewire cable that suits the firewire ports of the Camera (DV OUT Port) and your computer.
Connecting the computer and the CCU using a firewire cable
Connect one end of the firewire cable to the DV OUT port of Camera.
Connect the other end of the cable to the firewire port of the computer.
HD videos can also be transmitted using a HD grabber card. In this case, HDMI out of a Camera Control Unit (CCU) can be connected to HD grabber, which in turn can be connected to computer through a Firewire or USB 3.0 port.
This may happen due to the firewall on the computer, which may reduce the bandwidth, and you will get low speed. Please shutdown the firewall and check speed. (You may check the bandwidth on http://www.speedtest.net)
If the bandwidth is substantially more than before, make relevant configuration changes to the firewall and restart.
If you have an IT team or IT personnel in your hospital, then please contact them for the same.
Any Laparoscopic/ Endoscopic surgeon who wishes to watch videos of other Laparoscopic surgeons can register on LapGuru portal. Also any hospitals or medical institutes can become a member on this portal.
All users, by default, are viewers. If you wish to transmit your surgeries please contact us on- support@lapguru.com .
LapGuru is an information repository for the less experienced surgeons and a perfect platform for the experienced surgeons to share their knowledge. LapGuru has a number of registered surgeons who are available to answer queries during surgery if they are invited to the surgery transmission and where surgeons transmit the videos of their live surgeries for the other less experienced surgeons to watch and learn.
Newly registered users are by default enrolled under Basic plan which is free. Other Viewership plans will be published soon on www.lapguru.com. Contact us on- info@lapguru.com for viewing premium content.
Yes. You must register on the LapGuru portal in order to watch the surgery video. Registration process is very simple and it hardly takes 2-3 minutes time.
On the LapGuru Home Page, click Register. The LapGuru Registration page appears
The fields marked with an asterisk (*) are mandatory. You must type the information in these fields.
Click Register. You will get a confirmation email from site.admin@lapguru.com on successful registration on the email ID you registered with on LapGuru portal.
Store the email which you receive from LapGuru for your future reference, as the same will have your Login details. Do not share your user ID (email address) and password with colleagues, family, or friends. If they wish to use LapGuru, invite them to register.
Wait for 5-10 mins after completing the registration form to get the email from the LapGuru portal.
Click Refresh button on your browser once to check whether you have got the mail.
Check the Spam folder in your mailbox. Sometime, due to anti-spam settings, the mail may go into Spam folder. If you can see the mail in Spam folder, mark as Not Spam (so that the mail will be moved to your Inbox) or Add the user- site.admin@lapguru.com to your contact list.
Click on Request a new password link on the Login box that opens at the click of Login button on www.lapguru.com .
Enter the email address which you had filled up while registering on the LapGuru portal.
Once you enter correct email address, a new password will be sent to your email ID using which you can login into LapGuru portal. You may edit this password later by going to Edit profile page.
Below mentioned are the major steps to be carried out in order to transmit the Live surgery on LapGuru:
Connecting the CCU to the computer/laptop
For details on the connections, please refer Q. How to connect Camera unit to the computer?
Flash Media Live Encoder (FMLE) settings
Once the connections between the CCU and the computer are done, you need to start the Adobe Flash Media Live Encoder (latest version of the same can be downloaded from the Internet) to set the input device and configure the video type. This is the one time process which is carried out as mentioned below:
Start the FMLE.
FMLE detects the input device (Video Grabber Card) that you have connected to your computer. You can see the VGC details in the FMLE window.
The Device drop down list in the Video section of the Encoding Options tab lists all the video devices
From the Device drop down list, select the video device that you have connected to your computer as shown below.
To configure this video device, click Video Capture Device Settings A new Settings window pops up.
The Settings window enables you to configure the video device.
On the Settings pop up window, select the Crossbar tab.
Depending on your computer – CCU connections, select either ‘Video Composite In’ or ‘Video S-Video In’ from the Input dropdown list.
On the Settings window, select the Video Decoder tab.
Select relevant Video Standard from the dropdown list.
Click OK.
The FMLE now shows you the video from the Laparoscopic / Endoscopic Camera you are connected to.
The FMLE settings are now complete. Close the window.
Login to LapGuru portal- www.lapguru.com using your registered email ID & password.
Schedule a new surgery event for transmission
Click on button.
Fill in the required details in the form and click on Save button.
The surgery schedule that you have created can be seen on the Live Surgeries tab.
Click on button.
When you click on this button, the Flash player window will start. Click on Play button on this player and your surgery transmission will start.
The number of users who can transmit the live surgeries has been restricted on LapGuru. If you do not have Transmission rights, you will not be able to see button and you can only view Live or Recorded Surgeries on LapGuru based on your membership plan.
The surgery schedules are removed from the Live Surgeries tab once the date for which it was created is already passed. Hence if your surgery schedule was created for a past date, you will not be able to view the same on Live Surgeries tab now, and you will have to create a new schedule by clicking on button.
The surgery schedules are removed from the Live Surgeries tab if the same does not start within 10 hours from its start time.
You may click on Edit transmission , make changes in the date & time and click on Save. The changes that you made will be automatically reflected on Live Surgeries tab.
Yes. You can click on Delete surgery transmission to cancel or permanently delete a surgery schedule that you have created. However, please note, once you confirm this action, you cannot retrieve the deleted surgery schedule back and you will have to create a new surgery event.
Yes. You may have a Private transmission through LapGuru, and only people having its unique transmission code will be able to watch the same. To create a private surgery schedule:
Click on button, after logging to your LapGuru account.
Select Access Level as Private using toggle button
On the click of Save. A unique transmission code will be generated and displayed by LapGuru. You can see the same on Live Surgeries tab too such as
Send this code to the people you wish to invite to watch your transmission. Only such viewers will be able to connect to watch your private transmission.
Yes, the same can be done using LapGuru Conference feature. For creating such conference schedule:
Go to Conferences tab after Login to your LapGuru account.
Click on button.
Create a conference schedule by filling up details in the form such as, Conference title, Start & End Date, and add names of surgeons who are going to transmit surgeries under this conference by clicking on Select Conference access.
The select conference access shows the list of current LapGuru transmitters.
Once the conference schedule is created, the transmitting surgeons may add surgeries to that conference by clicking on button.
Viewers will be able to see button under this conference schedule. When they click on the same, they will be able to watch all current Live surgeries on the single player page.
The audio for each surgery will not be available on this conference page. However, viewers can go to individual surgery page to get all surgery details along with audio.
Please ensure that your microphone is properly connected to the computer. The Flash player automatically detects the microphone that is connected to your computer.
In the Flash player window, Right-click and select Settings.
Click Flash player should show the microphone that is connected to your computer. If the sound is ON, then it will show bars as per the intensity of the sound in the setting below.
Using the inbuilt microphone of the laptop can create an echo and can cause a lot of disturbance to the other users. Do not use the inbuilt mic of your laptop instead use a separate headphone and microphone.
When the speaker is used to transmit audio (like in an auditorium) the user/ trainer should use a unidirectional microphone, otherwise, the audio coming from the speaker will be fed back to the mic and may create an echo.
Please make sure that the connections between your CCU and the computer/laptop are properly done. For more details about connections, refer How to connect Camera unit to the computer?
Start Flash Media Live Encoder (FMLE) and see whether the video from input device can be seen. For more details about FMLE settings, refer what is the procedure to transmit the video of my live surgery?
Please make sure you have installed Adobe Flash Player (version 11 or later). The same can be downloaded from the Internet: http://get.adobe.com/flashplayer/.
If you have installed the correct version of Adobe Flash player as mentioned above, the Flash player window should start as soon as you click on
After clicking Play in the Flash player window, if your computer or laptop does not detect the input video from the Laparoscopic / Endoscopic Camera:
Right- click the player window and select Settings.
Click the Camera in the Adobe Flash Player Settings window and choose your video capture card from the list.
Click Select Allow and Remember.
Now, you need not click Allow every time you start the flash player
Quality of the video on the projector depends on the quality of the transmitted video. A SD video transmission will look blurred or pixilated on a projected screen, however, if the video is transmitted in HD, the pixilation would be minimal or not there at all.
If you are unable to watch any surgery video, please ask your network administrator to check for network connections, and Firewalls. If you have a firewall enabled on your network then the ports 1935, 554, 80.
(1935-RTMP, 554-RTSP, 80-HTTP) should be opened up in the firewall.
The video quality depends on the source of the video, the bandwidth available at the transmitter end and the type of the transmission (SD, SD+, HD are the types in increasing order of quality). The quality of the video also depends on the speed of the viewer’s Internet connection (bandwidth). Typically, SD will require around 500 kbps of bandwidth, SD+ will require around 2Mbps of bandwidth and HD will require around 4 Mbps of bandwidth.
If the video is getting transmitted at bandwidth higher than that of your available bandwidth, you may see a jerky or choppy video. Ideally, the viewer needs to have same download speed as that of the uploading speed of the transmitter.
To check the speed of your Internet connection, please visit http://www.speedtest.net and click on Begin Test.
Yes. You may click on the Exit transmission on the flash player window anytime to quit from viewing the video transmission. You may click on again anytime and watch the surgery till the time the transmitter is transmitting the surgery.
Yes. You can re-connect once again and watch the same surgery. However LapGuru keeps the Watch Transmission button active only till next 10 hours of start time of surgery or till the time the transmitter has not stopped it.
Such error message usually comes only when you are using Google Chrome web browser (and not in Firefox or Internet Explorer). This error comes due to the way Chrome handles Flash content. Conflicting flash installation causes crashes.
To resolve this problem, follow the below mentioned steps:
Open Google Chrome browser window and type about: plugins orchrome://plugins/ in the address bar and press Enter.
You can see the list of all plug-ins installed in Chrome.
Look down the list of plug-ins for the Flash entry. If the entry looks like Flash (2 Files) there is a very good chance the source of your Flash-related crashes is a conflict between the two.
In the upper right hand corner of the browser window there is a small button labeled [+] Details. Click on that to expand the entries for all the plug-ins. Return to the entry for Flash.
You should see something like the screenshot above: two entries for Flash, one for the internal Chrome installation (highlighted in red here) and one for the host OS’s installation (seen below the highlighted entry).
You need to click on the Disable link for Chrome’s internal installation of Flash- similar to the one marked in red (make sure you disable the one located in Chrome’s AppData folder and not the separate stand-alone Flash installation). Once you do so the entry for the internal installation should look like so:
Now close all the Google Chrome browser windows, and restart Chrome and go to www.lapguru.com to watch the surgery videos.
Doodle is an additional feature provided in LapGuru application that enables users to point at or mark a particular section of the ongoing surgery.
Through this function, users (transmitters as well as viewers) can draw an arrow mark , circle , rectangle or freehand drawing on the screen to point to a particular section during surgery and all the other attendees who have joined to watch the surgery transmission as well as the transmitter will be able to view the same on their screen.
The user may click on Erase Shape to clear the Doodle marks on his computer screen. LapGuru will erase the Doodle marks in 60 seconds automatically from all viewer screens.
Clear Screen erases the doodle marks on individual user’s screen only. Other attendees must click Clear Screen on their computers to erase these marks
No. The drawing once cleared from screen cannot be seen again. However, even though one user clears his screen, the Doodle marks which are already drawn will remain on all attendee's screens unless each user clears his screen or LapGuru will automatically erase it in 60 seconds.
Infospot is a feature that enables users to add their comments (just like having an online chat) while the surgery transmission is ON. Each of these comments gets tagged to the video position when the comment was added. A button is shown to all viewers which can be clicked to go to the particular video position when the comment was added.
Click on
Type your comments in the text box.
Click Send
All the users watching the surgery can read and reply to your queries/comments
A new Settings window pops up.
button. 
button.
, make changes in the date & time and click on Save. The changes that you made will be automatically reflected on Live Surgeries tab.
to cancel or permanently delete a surgery schedule that you have created. However, please note, once you confirm this action, you cannot retrieve the deleted surgery schedule back and you will have to create a new surgery event.
button.
button.
button under this conference schedule. When they click on the same, they will be able to watch all current Live surgeries on the single player page.
Flash player should show the microphone that is connected to your computer. If the sound is ON, then it will show bars as per the intensity of the sound in the setting below.
Select Allow and Remember.
in the Adobe Flash Player Settings window and choose your video capture card from the list. 
on the flash player window.
and click on Play
, circle 
, rectangle 
or freehand drawing 
on the screen to point to a particular section during surgery and all the other attendees who have joined to watch the surgery transmission as well as the transmitter will be able to view the same on their screen.
The user may click on Erase Shape 
to clear the Doodle marks on his computer screen. LapGuru will erase the Doodle marks in 60 seconds automatically from all viewer screens.
is shown to all viewers which can be clicked to go to the particular video position when the comment was added. 
provides a list of all the surgeons who have joined to watch the surgery transmission.