Remote surgery

Remote surgery (also known as cybersurgery or telesurgery) is the ability for a doctor to perform

Marketed for $975,000, the ZEUS Robot Surgical System was less expensive than the da Vinci Surgical System, which cost $1 million. The cost of an operation through telesurgery is not precise but must pay for the surgical system, the surgeon, and contribute to paying for a year's worth of ATM technology which runs between $100,000-$200,000.^{[citation needed][4]}

The Lindbergh Operation

The first true and complete remote surgery was conducted on 7 September 2001 across the Atlantic Ocean, with a French surgeon (Dr. Jacques Marescaux) in New York City performing a cholecystectomy on a 68-year-old female patient 6,230 km away in Strasbourg, France. It was named Operation Lindbergh,^[5] after Charles Lindbergh's pioneering transatlantic flight from New York to Paris. France Telecom provided the redundant fiber optic ATM lines to minimize latency and optimize connectivity, and Computer Motion provided a modified Zeus robotic system. After clinical evaluation of the complete solution in July 2001, the human operation was successfully completed on 9/7/2001.^[6]

The success and exposure of the procedure led the robotic team to use the same technology within Canada, this time using Bell Canada's public internet between Hamilton, Ontario and North Bay, Ontario (a distance of about 400 kilometers). While operation Lindbergh used the most expensive ATM fiber optics communication to ensure reliability and success of the first telesurgery, the follow on procedures in Canada used standard public internet which was provisioned with QOS using MPLS QOS-MPLS. A series of complex laparoscopic procedures were performed where in this case, the expert clinician would support the surgeon who was less experienced, operating on his patient. This resulted in patient receiving the best care possible while remaining in their hometown, the less experienced surgeon gaining valuable experience, and the expert surgeon providing their expertise without travel. The robotic team's goal was to go from Lindbergh's proof of concept to a real-life solution. This was achieved with over 20 complex laparoscopic operations between Hamilton and North Bay.

Applications

Since Operation Lindbergh, remote surgery has been conducted many times in numerous locations. To date Dr. Anvari, a

The possibility of being able to project the knowledge and the physical skill of a surgeon over long distances has many attractions. There is considerable research underway in the subject. The armed forces have an obvious interest since the combination of telepresence, teleoperation, and telerobotics can potentially save the lives of battle casualties by providing them with prompt attention in mobile operating theatres.

Another potential advantage of having robots perform surgeries is accuracy. A study conducted at Guy's Hospital in

In 2015, another test was conducted on the lag time involved in the robotic surgery. A Florida hospital successfully tested lag time created by the Internet for a simulated robotic surgery in Ft. Worth, Texas, more than 1,200 miles away from the surgeon who was at the virtual controls. The team found out that the lag time in robotic surgeries, were insignificant. Roger Smith, CTO at the Florida Hospital Nicholson Center said that the team had concluded that, telesurgery is something that is possible and generally safe for large areas within the United States.[9]^[10]

Unassisted robotic surgery

As the techniques of expert surgeons are studied and stored in special computer systems, robots might one day be able to perform surgeries with little or no human input. Carlo Pappone, an Italian surgeon, has developed a software program that uses data collected from several surgeons and thousands of operations to perform the surgery without human intervention.^{[11][unreliable source?]} This could one day make expensive, complicated surgeries much more widely available, even to patients in regions which have traditionally lacked proper medical facilities.

Force-feedback and time delay

The ability to carry out delicate manipulations relies greatly upon feedback. For example, it is easy to learn how much pressure is required to handle an egg. In robotic surgery, surgeons need to be able to perceive the amount of force being applied without directly touching the surgical tools. Systems known as force-feedback, or haptic technology, have been developed to simulate this. Haptics is the science of touch. Any type of Haptic feedback provides a responsive force in opposition to the touch of the hand. Haptic technology in telesurgery, making a virtual image of a patient or incision, would allow a surgeon to see what they are working on as well as feel it. This technology is designed to give a surgeon the ability to feel tendons and muscles as if it were actually the patient's body.^[12][13] However these systems are very sensitive to time-delays such as those present in the networks used in remote surgery.

Depth perception

Being able to gauge the depth of an incision is crucial. Humans' binocular vision makes this easy in a three-dimensional environment. However, this can be much more difficult when the view is presented on a flat computer screen.

Possible uses

One possible use of remote surgery is the Trauma-Pod project conceived by the US military under the Defense Advanced Research Agency. This system is intended to aid wounded soldiers in the battlefield by making use of the skills of remotely located medical personnel.

Another future possibility could be the use of remote surgery during long space exploration missions.

Limitations

For now, remote surgery is not a widespread technology in part because it does not have sponsorship by the governments.

See also

• Waldo (short story) by Robert A. Heinlein.

References

External links

Look up telesurgery in Wiktionary, the free dictionary.

• BBC News SCI/TECH -- First transatlantic surgery