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Technology

Robotic Surgery 101

Posted by michael from the cold-steel dept.
Raven42rac writes "Interestling article on my local newspaper's website dealing with a remote controlled, voice controlled, three dimensional surgery assisting robot."
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Robotic Surgery More

Robotic Surgery

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  • boring (Score:3, Funny)

    by Gizzmonic ( 412910 ) on Saturday September 28, 2002 @08:23PM (#4351751) Homepage Journal
    it's more fun to do an endoscopy with a controller-it's a robot, technically, but when you're performing the procedure, you can pretend you're playing "Small Intestine Wars." (for doctors only of course)
  • Voice recognition isn't really something you want to depend on for life-threatening items...

    i'm too dumb to think up of a witty conversation though...
    • what about:

      Hiccups?

      Burps

      Farts

      Sneezes

      Remember the "good ole days" when someone wanted to invent the voice-activated DVD player? You'd watch Top Gun, they guy would shout "EJECT EJECT EJECT" and the disk would come shooting out the machine at 200 miles an hour!

      No, I wouldn't trust it, either.

  • Three Dimensional Robot? (Score:3, Funny)

    by NitsujTPU ( 19263 ) on Saturday September 28, 2002 @08:25PM (#4351755)
    This is TRUELY revolutionary by relation to all of those 2 dimensional robots I see around.

    So, how does the doctor work with a 3 dimensional robot? Do you draw funny glasses on him?

  • Hmm (Score:2, Insightful)

    by SashaM ( 520334 )

    voice controlled, three dimensional surgery assisting robot.

    Hmm, has anyone ever seen a two dimension robot? Or four dimensional for that matter?

    • Re:Hmm (Score:2, Informative)

      by eggstasy ( 458692 )
      I guess he means that the robot has a full 3 degrees of freedom of movement: an arm that can move left and right, back and forth, up or down.
      A "2 dimension" robot would only be able to use two of the above pairs, a "1d" bot would only use one of the above, but I guess a "4d" bot would have to travel through time :)
      • The poster knew this I believe, and was lauding us with his commentary regarding the oftentimes silly and awkward nature of the english language.
        • "oftentimes silly and awkward nature of the english language"

          English is a proper noun. Capitalize it. Or would that be "Capitolize" it? Or "Capitolise" it?

      • Re:Hmm (Score:3, Interesting)

        by cybermace5 ( 446439 )
        Actually, a robot can have limitless degrees of freedom. Your fourth degree would be wrist rotation, for example. A fifth would be forearm extension, etc.
      • I guess he means that the robot has a full 3 degrees of freedom

        That doesn't sound like very much to me. It should have 6 degrees of freedom to move in 3 dimensions and turn in 3 dimensions. Maybe that is actually what he means when saying 3 dimensions.
    • Hmm, has anyone ever seen a two dimension robot? Or four dimensional for that matter?

      I swear I saw a two dimensional robot walking down the road the other day... but he turned left and completely dissappeared!!!

    • Re:Hmm (Score:1, Funny)

      by Anonymous Coward
      Hmm, has anyone ever seen a two dimension robot?

      Bite my shiny metal ass.
    • Hmm, has anyone ever seen a two dimension robot?

      Yes. The one that took me too literally when I commanded it to "go play on the freeway".
    • No, you misunderstood it. The robot assists with three-dimensional surgery. Before that, they only had robots operate on Flatlanders.
    • does this thread win the 'most posts in a row quoting the same phrase from parent' award?
  • I used to bike commute through Sunnyvale past
    one of these companies. The name "Intuitive Surgical" used to scare the hell out of me...

  • College paper has further coverage of Zeus company (Score:3, Informative)

    by jasonla ( 211640 ) on Saturday September 28, 2002 @08:37PM (#4351784)
    I attend UC Santa Barbara, and I work on the student newspaper, the Daily Nexus. We did an article on the technology and the company responsible for it a long time ago when Computer Motion made it's first attempt at telesurgery. Here's the article, yes, that's my name in the byline.

    http://www.dailynexus.com/science/2001/1555.html [dailynexus.com]
  • if its running windows (as it probably will :) ), the 'blue screen of death' will be so much more literal.

  • Very useful (Score:5, Informative)

    by NMerriam ( 15122 ) <NMerriam@artboy.org> on Saturday September 28, 2002 @08:41PM (#4351795) Homepage
    We use these at work and they are very good -- Intuitive Surgical and Computer Motion both have systems that are getting use in ORs all over the place.

    The only drawback is the cost and training, but once you've spent the million dollars to get it, you open up a lot of opportunities for surgical education and easing the burdon on doctors (as well as removing all notions of "distance" from the question of timely assistance).

    For those wondering about the voice control, it only recognizes a dozen commands, and is totally speaker-independant. You'd say "Aesop...Move in" and it will move the camera in a few millimeters. The nice thing is that you can save positions and pricisely jump back and forth at looking in different areas in a half-second. It does have pressure sensors, so you can't do too much acidentally.

    Also, realize that sometimes you can spend literally 16+ hours on one surgery -- having the robot do the direct manipulation means you can switch surgeons every few hours or get up and walk around without letting go of the surgical instruments and possibly abrading something while handing them off.

    After watching a few dozen of these surgeries, i'd honestly say that i'd rather have my gall bladder removed by hermes/aesop/Zeus/daVinci than by a surgeon's hands...
    • I isn't just the ability to "time share" between doctors and having a voice controlled camera that I think makes these things so useful. It's also the precision with which they can work.

      According to the article, the size of the incision required is much smaller that you could ever have if you needed to fit your hand in the opening. The smaller the hole, the less traumatic and the shorter the healing time.

      Because the system can filter out jitter in hand motion, as well as scaling hand motions down to a smaller scale, the surgeons can also be much more precise than they could if the controlled the tools with their bare hands.

      I was surprised to read that the one of the drawbacks to this system was that sometimes the old way, with the larger incision and I am assuming manually done, is better at sparing the nerves in the area of the prostate. Anything that can do this accurately enough to preserve those functions is all right by me. Quite all right. If I had to chose, give me that "Ol' School" if it keeps things working. I would have thought that by changing the gain on the device, it would be even more precise than mere human hands.

      The voice controlled camera is neat, the ability to perform surgery a million miles away is cool, but the meat and potatoes of the system is the precision control of the surgical instruments and all of the pain that it can save the patient. Both because of the smaller incision and the greater precision afforded the doctor.

      • Re:Very useful (Score:3, Insightful)

        by NMerriam ( 15122 )
        According to the article, the size of the incision required is much smaller that you could ever have if you needed to fit your hand in the opening.

        They are the same size as any other laparoscopic openings -- about big enough for two fingers. The robot isn't making any difference to the recovery time or incision, it is mostly an aid to the surgeon who is already doing laparoscopic procedures (and is already used to doing surgery from a 2d TV image).

        You're right about scaling of motions -- right now it isn't such a HUGE deal (although the fine control is handy as I said in being able to rest wihtout moving instruments) but in the future the same tech will be used for more and more precise surgeries that aren't even attempted today...
      • the ability to perform surgery a million miles away is cool

        That'd be an 11 second ping. I'd imagine that'd put a big damper on the snappy telepresence feedback loop.

        --

  • Some predict it will change the course of surgery. Already, specialists are operating on patients halfway around the world.

    nice... I can just imagine

    Doctor places robot arm around chest, says "begin incision"... arm starts cutting downard.

    Netsplit

    I'll let you think up the gory details...

  • I don't even want to think of the consequences of a surgeon using this, making a mistake, and cursing himself..."dam it" probably would have meaning to the little robot, and even worse results happen with more vulgar words.

    SURGEON: Fuck!
    ROBOT: Beep.
    ROBOT complies with SURGEON's request, immediately going to work on the patient.

  • 2nd Hand Experience (Score:4, Informative)

    by Pave Low ( 566880 ) on Saturday September 28, 2002 @09:19PM (#4351890) Journal
    My girlfriend is a PHD student, and she is currently doing research in medical technology. Recently she's had a demonstration of this device. After that demonstration, they were allowed to handle the machine and try some manipulations.

    From what I understood:
    1. This is not an intelligent robot, but a tool for the surgeon. Sensors are connected to the surgeons hands and arms, and they are transmitted to the operational device. It still is the surgeon which does the operation.

    2. Resistance, which I saw mentioned in one of the other responses, is simulated to the surgeon doing the operation. Thus, a more 'natural' feel is created.

    3. This device and devices like it are great tools for Minimal Invasive Surgery (MIS). Because the opening doesn't have to be large at all, and devices can be sterilized, this greatly reduces the risk of infection.

    4. If developments continue along this line, and there is no reason to believe they won't, operation rooms may become obsolete for many operations: a closed sterile device is pressed against the area where the opening has to come. All that has to be sterile is the insides of the operation device.
    • If developments continue along this line, and there is no reason to believe they won't, operation rooms may become obsolete for many operations: a closed sterile device is pressed against the area where the opening has to come. All that has to be sterile is the insides of the operation device.

      not for a while, at least -- keep in mind that you have to be able to open up the patient in case something goes wrong...
    • please note " a surgery-assisting robot", not a "surgery-performing robot"
  • First a 3 dimensional monitor [slashdot.org], now a three dimensional robot?!?!

    Good lord, pretty soon we're going to have 3d plants, trees, maybe even people!!!

  • What exactly is a "Robot"? (Score:3, Insightful)

    by timeOday ( 582209 ) on Saturday September 28, 2002 @09:28PM (#4351910)
    To me this machine sounds very much like a back-hoe, except that it makes motions smaller and more precise instead of larger and more powerful.
    • A robot is a device that can be programmed
      to move in three or more degrees of freedom
      (read joints).
    • I for one wish that the media would stop referring to human-controlled devices as robots, reserving that word for something that can perform its actions autonomously. I.e., if someone could tell a machine, "Remove this man's appendix" and it would perform the operation without human guidance (though, perhaps with human oversight), that would be a surgical robot.

      One replacement word for robot in this context is the term waldo [dictionary.com] , taken from the Heinlein story of the same name. Thus, this is not a surgical robot, this is a surgical waldo; the space shuttle has a waldo arm (not a robot arm); and there's a well known TV show that should really be called "Waldo Wars".

      It would certainly help to make stories such as this one clearer in the long run (once the term gained a wide usage). I recall that the last time a surgical robot made an appearance on slashdot, there were several commenters that thought the story was referring to a device that could perform surgery on its own, so even a tech-oriented crowd would benefit from a better choice of terms.

  • Does it say

    "Please sate the nature of the medical emergency"
  • The questions we are all holding back:

    a) Does it run Linux?
    b) Can you get an aimbot or other cheat codes?
    c) How many stupid questions are there?
    d) Is it depressed?
    e) Is it's name Data?

    Man I am tired :/
  • I did not spell interesting "interestling" in my post, Michael :p
  • They use something like that here in London Ontario for robotic Heart Surgery. THey make 3 tiny incisions and operate. Really cool. They also have a 3d headset. I was really blown away by the precision
  • What if the surgeon was using one of those machines long-distance in a dramatic telesurgery operation, and the network suddenly lagged out? Or if someone else in the OR on a 24-hour shift knocked out a CAT-5 cable?

    Not because I hate technology, but because I know technology, I wouldn't trust being operated upon by a remote-controlled robot.
    • Most of these systems came out of research coordinated by DARPA and SRI. The designs do take latency and network failures into account -- original idea was to get war casualties patched up ASAP while keeping hard-to-replace surgeons a little bit more out of harm's way.
  • My father works for a division of Medtronic (Powered Surgical Solutions) that is testing tactile-feedback versions of these devices. They work like force-feedback joysticks.
  • "Dammed hackers! Now, put my fucken eyeball back in my head instead of my ass!"
  • Robots can do surgery. Next thing you know it robots will be deprogramming people from cults. Which reminds me of 937, the cybernetic deprogrammer cat in the web's newest anime: Banana Chan! [geocities.com]
  • ...that the robots are controlled by professional, licensed doctors, and not by macaques from 600 miles away [slashdot.org].

  • ISS (Score:3, Insightful)

    by Tablizer ( 95088 ) on Saturday September 28, 2002 @11:10PM (#4352111) Journal
    Why can't they put something like this in the International Space Station to do experiments instead of expensive, risky humans?

    • Why can't they put something like this in the International Space Station to do experiments instead of expensive, risky humans?

      wasn't one of the targets for the ISS is to learn more about humans working in space ?

      also, don't forget that educated, capable humans are still the smartest, most adaptable machinery known, by quite a large margin ...
      • (* wasn't one of the targets for the ISS is to learn more about humans working in space ? *)

        How many do you need for that? We already dumped almost half a Mars mission of funding into that tin can.

        I think studying remote work technology is at least as important.

        (* also, don't forget that educated, capable humans are still the smartest, most adaptable machinery known, by quite a large margin ... *)

        Including the remote humans behind the controls and 3D cameras.
        • How many do you need for that? We already dumped almost half a Mars mission of funding into that tin can.

          I think studying remote work technology is at least as important.

          Perhaps the ISS is a budget-sink, I believe, however, that human colonization of space certainly isn't. For this we need both RC research, and long-term human space-habitat R&D. The ISS may be a flawed, over-priced means for this target (to this I agree), but the target itself is worthwhile. Actually, IMHO,it is one of the most worthwhile targets humanity has today, if it wishes to survive, much more so than a Mars 'mission' (though, as a researcher, I do not object to scientific research, Quite the contrary ...).

          ... humans are the most capable ...

          Including the remote humans behind the controls and 3D cameras

          I beg to disagree, for the following reasons:
          1) time delay. A human several seconds away is less capable.
          ( Oh, and BTW, for the purpose of a mars mission this 4..20 light-MINUTES away, as the pathfinder incident painfully demonstrate ... )

          2) Robotics, AFAIK, is currently nowhere near to achieve the versatility, flexibility, sensory abilities, self-healing and various other advantages of a pair of human hands. Not to mention the natural control mechanisms (healthy) humans have for them, and for the motion of the torso.

          Though it is true that for some applications outside the normal parameters (scale, or repetetiveness) of human-action, (like micro-surgery, or handling large structures, or many identical actions on a production line), robotic extensions can be better than the natural mechanisms, it is still not so for most non-simple , human-scale activities.

          It may be so one day, but it sure isn't today.

  • Just wait a few years and pirate copies will appear in Asia that allow one to do self-surgery if you hook up an NC machine or Lego Mindstorms (use supergrlue) to your PC.

    Imagine going through a drop-down menu with items like "Historectomy", "Lobotomy", etc.

  • Uh oh.

    "A little to the left .. a little more .. AAGH! FUCK! Wait! NO! Don't do THAT! Crap! DAMNIT! Someone turn this thing off! NO! NOT THAT THING!"

    Heh. Sounds like trouble.
  • "Left!" "Fuck! No! Right! Right! Right!"

    "You weren't planning to have kids, were you?"
  • "Interestling" indeed!
  • The whole thing is computer-assisted gimmickry.
    Computer Motion has been pushing this system for a long time.
    It's just a way of selling really expensive toys to surgical centers
    that want to "look" cutting edge.

    The Hermes voice recognition is clunky.
    most of the hardware running this thing is over eight years old.
    Sure, if the doc is trained on it, they can make it do things
    but it really de-augments the surgeon's abilities.

    Like tying a brick onto a pencil. You can write with
    it, but certainly not any better than before, and
    probably much worse.

    If you're doing component placement on some pc boards
    or manipulating other consistent man-made items, robotics
    work well. Working on wetware is a whole other thing.

    Every case is different. Stuff moves, sags, and flows.
    A surgeon with good hands can be quicker and much
    more precise. It's all about the surgeon's heightened
    senses of touch, vision, hearing, even smell.
    This thing only gets in the way.

    It does Computer Motion and it's OEMS a lot of money though.
    The cameras, voice control box, the arm and it's
    attachments, training will run you way past a quarter Mil
    for each surgical suite. It does everything but give the best
    in patient care. It also makes for slick copy in the annual report.

    Think about something much simpler like cutting your food
    and feeding yourself. Now imagine doing it with voice control
    and a joystick. Sure you could eventually learn to do it, but
    how much more efficiently and skillfully can you do it using
    your hands, a knife and fork?

    Point that thing someplace else.
  • This sort of stuff has been around a loooooong time. I was the resident back in Feb 2001 for a surgeon by the name of Martin Fried (pronounced Frede) who was Belgian, and did a lot of work with AESOP, his pet robot, before coming to Scotland. The funny thing was he went from (at the time) the cutting edge of surgery to work in a shitty District General Hospital where he ended up doing varicose veins and hernias for a few months, before, unsurprisingly, resigning and going back to his Professorial unit.

    So this is at least 2 years out of date - a long time in cutting edge technological terms. What next on the front page of Slashdot - the pentium 3 arrrives? Just because it's the first time its been used in a sleepy rural town doesn't change its redundancy.

    The robot though is apparently great - you can tell it to remember positions (e.g. a camera position for a good view of something) and then, later, just tell it to go back to position A or whatever, and you get it in exactly that same good view. And it doesn't tire or move, which can be a problem in long operations when you are holding up the big fat liver and big fat bosom of some big fat fatty who needs their gallbladder out because every big mac hurts, and is too fat for keyhole surgery.

    In a few years when the operation is done entirely by the robot, with no human intervention whatsoever, then I'll be impressed. Unfortunately, I'll also have to get a new job.

  • I'm on staff in the Urology division at Mayo Clinic in Rochester. Mayo [mayoclinic.org] has some information on the web [mayoclinic.com] regarding prostate cancer. I would discourage anyone here from trying to influence someone to have their prostate removed via a robot (i.e.da Vinci) for several more years.

    Here at Mayo, we have performed the most RRP's (radical retropubic prostatectomies) than anywhere in the world. We have the largest database of patients that have had them out. So we have some authority to make these recommendations. It was not 1 month ago that the chair of the department, another surgeon and I were discussing this and the conclusion was that for the next year or two we can't offer prostatectomy removal by da vinci and offer the same low degree of complications as you can offer with RRP.

    In prostate removal, the primary goal is removavl of the cancer. Secondary goals are preservation of quality of life such as 1)continence - the ability to control your urine and 2)erections - preservation of the nerve pathways at time of surgery. Since the nerve pathways run past the seminal vesicles directly next to the prostate it requires delicate excision to preserve these. You won't enjoy the same success statistics for quality of life if you have your prostate removed by robot right now.

  • My four-year-old daughter had heart surgery a year ago; the surgeon (Dr. Michael Black at Stanford) performed the surgery using a Computer Motion robot. I have nothing but great things to say about this technology. It is real.
  • These robots have been around for a while and are useful but most are just assistants for the primary surgeon or can perform limited operations like biopsies.

    I'm working with a project to build the first ambidextrous, MR compatible neurosurgical robot. Rather than simply being an assistant it will perform the surgery itself, controlled by a surgeon in another room. All this inside an MR scanner.

  • This isn't comprehensive, but I remember some work at IBM Research starting back in he mid-1980s by a guy named Russ Taylor on robot-assisted surgery. At the time the approach was focused on ways to improve the success rates of hip replacements by improving the accuracy of size, orientation, and placement of the hole drilled in the bone for the artificial joint.

    I've seen two things recently about this, namely Russ Taylor is now a professor at Johns Hopkins where he's doing more robotic surgery stuff [jhu.edu] from the sound of things.

    In addition, I ran into a bunch called Integrated Surgical Systems [robodoc.com] that cite Taylor's work, though without naming him.

  • Let's hope the input buffer of this one accepts more than 2 'wrong' commands.

    Appologies to those who haven't read Rama 2...
  • Mathematics, rightly viewed, possesses not only truth but supreme beauty --
    a beauty cold and austere, like that of a sculpture, without appeal to any
    part of our weaker nature, without the gorgeous trapping of painting or music,
    yet sublimely pure, and capable of a stern perfection such as only the
    greatest art can show. The true spirit of delight, the exaltation, the sense
    of being more than man, which is the touchstone of the highest excellence, is
    to be found in mathematics as surely as in poetry.
    -- Bertrand Russell

    - this post brought to you by the Automated Last Post Generator...

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