Robotic Surgery Offers New PossibilitiesRobotic Surgery Offers New Possibilities

Over the last six months, 22 patients in North Bay, Ontario, underwent operations that might have seemed more likely to take place in a freaky science-fiction movie than in a Canadian hospital near the Great Lakes, a region known more for fishing in the summer and cross-country skiing in the winter.

The variety of complex laparoscopic operations--which included colon cancer procedures and hernia repairs--were performed on the patients by a three-armed robot controlled remotely by a surgeon more than 250 miles away. (A local surgeon was present with the patient to set up the robot and to assist in case a complication occurred; none did.)

In October, these kinds of telerobotic-assisted medical procedures will be tested in a 10-day experiment undersea in Key Largo, Fla., in a project called NASA Extreme Environment Mission Operations, or NEEMO 7 Mission.

The underwater mission will simulate the sort of harsh environment and extreme conditions found in space, so that eventually robotic-aided emergency surgeries might, for instance, be performed on space shuttle astronauts. But the mission also aims to prove concepts that could apply to patients in remote locations on Earth, like researchers in Antarctica, soldiers on battlefields, or accident victims in rural communities that lack critical medical expertise.

Without emergency surgery, "head-injury patients will die within the first few hours, yet it's easy to drill a hole in the skull to remove pressure on the brain. Robots can do this," says Dr. Mehran Anvari, professor of surgery and director of the Centre for Minimal Access Surgery at McMaster University in Hamilton, Ontario, a participant in the NEEMO experiments.

Anvari, who performed the 22 robotic-assisted surgeries on the North Bay patients this year, says the NEEMO experiments, which will include simulated operations on mock patients, "will teach many lessons."

Those lessons include zeroing in on the types of improvements that will be needed for medical robotics in order to make it more attractive to mainstream hospitals, including reducing the price of the surgical robots from about $2 million to less than $300,000, as well as making them lighter than the 1,200 pounds they weigh today, he says.

Also, haptic or touch-sensory technology is being improved so that when used with medical robotics, surgeons can "feel" a patient's body parts, like tiny blood vessels, while remote procedures are being performed. Algorithms that compensate for the network latency in remote "touch" sensory are also being developed, Anvari says.

The NEEMO mission hopes to examine whether remote surgeries can be safely performed without a doctor present with the patient, as was the case in the North Bay operations. Those "life-or-limb" remote surgeries on Earth could greatly improve the survival of critically injured individuals, in which the time needed to transport a patient to a medical facility miles away could instead mean "losing the patient," he says.

The robot used in the North Bay surgeries features "right" and "left" arms that are secured to a patient's bed and are controlled by Anvari during the procedures. The third arm holds a camera to view the patient and is also controlled by Anvari. The telecom network supporting for those North Bay robotic surgeries, as well as in the upcoming NEEMO missions, is a medical-grade, secure IP network provided by Cisco Systems.