Scientists, doctors and technology companies are developing
portable robotic units that can perform complex surgical procedures
remotely from any location.
Imagine emergency open-heart surgery being performed by a robot
surgeon in an ambulance parked on a street. This might be a real
possibility in a few years.
"When the mock surgery was a success, we realized a portable
robotic unit would be a viable option," said Dr. Mehran
Anvaridirector of the Centre for Minimal Access Surgery.
In the future, a multi-armed robot would perform the operation
under the direction of a surgeon manipulating endoscopic cameras
from a remote workstation.
The robot would act as the eyes and arms of the surgeon.
This type of portable robotic unit is being developed by the
Centre for Minimal Access Surgery (CMAS), a Hamilton, Ont.-based
research institute, in partnership with Bell Canada, which is
providing the advanced telecommunications needed for the
project.
The portable robotic unit is being touted as an important
achievement in tele-surgery that involves sophisticated robots
mimicking a surgeon's hand movements from a distance.
"Robots have been used in operations where surgeons have been
present in the same room. With this unit, it will be the first time
a robot would be operating when the surgeon is at a different
location," said Harvey Stein, senior director of solution
architecture at Bell Enterprise Group.
"Our target is to complete this project in the next five years,"
said Dr. Mehran Anvari, director of the CMAS.
He said the portable robotic unit would be used in space
missions, war zones and other environments where access to surgeons
is extremely difficult. "It may also be used in remote regions of
the Canadian North, [from] where the government spends millions of
dollars to transport patients to city hospitals," said Anvari.
The development of the robotic unit is part of a bigger mission
that began three years ago as a partnership between the CMAS, NASA,
the Canadian Space Agency, and several technology companies
including Bell Canada and Cisco Systems.
Dubbed NEEMO 9 (NASA's Extreme Environment Mission Operation),
the coalition has been working to test the efficacy of tele-surgery
in outer space.
A key goal of the NEEMO 9 coalition was assembly of a robotic
unit that would allow physicians to perform surgery remotely in
outer space. In April this year, a mock surgery was conducted at a
laboratory station 67 feet (20 meters) below the sea near Key
Largo, Florida.
B Anvari directed the surgery from his high and dry office
in Hamilton while the robot operated undersea.
"When the mock surgery was a success, we realized a portable
robotic unit is a viable option," said Anvari.
However, experts agree much work needs to be done before the
portable robotic unit becomes a reality. A major limitation is the
time delay, or latency, that occurs when the video images and
signals controlling the robotic arms are transmitted over long
distances to the surgeon.
To explain how latency affects actions, Anvari gave an example
of the simple task of drinking coffee. When a person raises a cup
to his mouth, he knows the action will end with it touching his
lips. If latency were to affect this action, there would be a gap
of few milliseconds during which the person would be unsure about
the final destination of the cup.
"When we perform surgery we cannot afford such moments as the
stakes are very high."
Previous research has shown that surgeons can adapt to latencies
of 200 milliseconds to a maximum of 500 milliseconds. However, the
latency surgeons would encounter while using the robotic unit over
long distances would be longer, about one second. "We have to find
a way to manage this problem," said Anvari.
The NEEMO 9 mission tried to find a solution to this problem,
and this research is being taken further by the CMAS.
Another concern is the cost of a portable robotic unit. Anvari
said the commercialized unit will be affordable, and scientists
working on tele-robotic surgery at other research facilities
agree.
"As tele-surgery evolves, the costs will continue to decline. In
the long run, tele-remote medical care will, in all probability,
become the most cost-effective avenue," said Dr. Christopher
Schlachta, medical director at the Canadian Surgical Technologies
and Advanced Robotics, a London, Ont.-based research centre.
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