Imagine a future where robots perform surgery on humans. Imagine being operated on by a doctor in another city, country or even planet
Digital Journal — Today, robotic surgery is turning medicine into another field boosted by technology. A surgeon’s hand movements control robot arms inserted inside a patient’s body, minimizing the risk and recovery time required when cutting someone open. The surgeon sits at a console — it could be two feet or two time zones away — and peers into binocular-like lenses at images provided by the tiny camera inside the patient. The doctor guides the robot arms by twisting a set of handles, moving his fingers or tapping foot pedals to focus the camera.
Call it video games meets health care, with a nostalgic nod to those toy-grabbing machines. Or you can simply name it after its basic elements: distance (tele) and medical operations (surgery).
Telesurgery removes the doctor from the scene entirely, transmitting the surgeon’s movements via high-speed broadband networks. To surgeons this means the potential to operate in environmentally hazardous situations like natural disaster zones or chemical contaminations (think Hurricane Katrina or SARS). To the average person it means avoiding potentially risky travel from a remote community while still being able to receive treatment from an expert surgeon.
One of the more popular systems available is Intuitive Surgical’s da Vinci, which can assist everything from heart surgery to prostate gland removal to infertility operations. Da Vinci’s use has grown from 1,500 procedures five years ago to an estimated 20,000 last year. But machines can’t control themselves (yet) and doctors like Mehran Anvari are paving the road to robotic Wellville. Working out of the Centre for Minimal Access Surgery (CMAS) in Hamilton, Ontario, Dr. Anvari has already performed telesurgery 1,300 miles away on a fake patient — a rubber body 67 feet below the ocean surface off the coast of Florida. What’s the point? To test the potential of telesurgery for use in emergencies on space stations or on future missions to Mars.
On a more local level, CMAS is also developing relationships with remote Canadian communities such as Chicoutimi, Yellowknife and Nunavut, and Anvari plans to visit Haiti to investigate the island’s telesurgery possibilities.
“The promise of telesurgery is enormous,” says Dr. Christopher Schlachta, medical director of Canadian Surgical Technologies and Advanced Robotics (CSTAR), another leader in telesurgery research. “Canada in particular is one country that stands to benefit enormously. Every year we spend hundreds of millions of dollars related to transferring people from remote regions to academic centres.”
Spreading telesurgery effectively also means updating the hardware. CMAS has partnered with the Stanford Research Institute to develop a next-generation robot featuring six to eight arms (instead of the usual three) that can detect each other’s positions. The Pentagon recently awarded a team of companies $12 million (US) to develop robots that could perform full surgery on wounded soldiers on the battlefield.
Before widespread adoption is possible (fewer than 300 hospitals use robotic technology), several aspects of telesurgery still need fine-tuning: the ability to translate the sense of touch (haptics) for the surgeon; freedom of movement inside the patient’s body cavity; and the quality of broadband networks to prevent time delay. As Anvari explains, “Time delay is a challenge because we have to compensate. When you are working on a patient and you make a move, the move takes some time to occur.”
Telesurgery is an exciting development in the medical world not only for its ability to minimize recovery times, but also because it brings surgery to patients who usually travel miles for it. That will make surgery easier and cheaper in the long run. Anvari says hospitals will save money because they’ll avoid costly patient transfers and lengthy hospital stays. What he would like to see is less focus on the surgeries’ costs — up to $5,000 extra per operation — and more attention paid to eventual value. “It’s like the first-generation computers — they are costly because you have to buy something that is not that common. But as the use increases the cost will drop significantly.”
And it’s only a matter of time before robotic surgeons make house calls, rendering waiting rooms obsolete.
HOLO DOC
Medicine, soldiers and holograms. Which one doesn’t fit? If Dr. Richard Satava has his way, all three will work in chorus on the battlefield. Under Satava’s direction, the U.S. Defense Advanced Research Projects Agency (DARPA) is working on the Virtual Soldier Project, which will use MRIs, CT scans and X-rays to create a holographic medical picture of a soldier’s body. Sort of like a “before” picture to compare with any injuries, the profile will be accessible through dog tags and will display a hologram of a soldier’s abnormally shaped organ, for example, to determine if that condition was congenital rather than acquired in combat.
