ROBOTIC TELESURGERY: AN INVESTIGATION OF UTILITY, HUMAN ADAPTATION, AND PERFORMANCE
Robotic surgery is a powerful, new method for performing minimally invasive surgery (MIS). The method allows complex procedures through incisions which are 10 mm or less. Robotic surgery has grown rapidly because small MIS incisions result in rapid patient recovery compared to conventional methods. Although surgical robots have the potential of long distance control, insufficient data is available to determine whether long distance robotic surgery, or telesurgery, is practical. Telesurgery could provide multiple benefits, including dissemination of expertise, widespread patient care, cost savings, and improved community care. We describe a series of experiments to investigate telesurgery using a one of a kind telesurgery platform and ground- and satellite-based Internet networks. The networks provided the redundancy and quality of service that would be required for human surgery. Tolerances for performing surgical tasks over a long distance were unknown. We show that operators using the platform can complete dry lab manoeuvres with communication latencies up to 500 ms, with no appreciable increase in error rates. Such latency would be equivalent to a North American transcontinental distance, implying a wide range of telesurgical capability. The characteristics of ground- and satellite-based Internet networks for telesurgery were unavailable. We demonstrate that emulated surgery in animals can be effectively performed using either ground or satellite. The networks can reliably support surgery, and satellite-based surgery can be performed even though latency exceeds 500 ms. Further, satellite bandwidth should be above 5 Mb/s for telesurgery applications. Satellite networks could be used either for back up or primarily where a community does not have ground-based equipment. iii Methods of training operators for telesurgery had not been explored. We demonstrate two methods of training for telesurgery. Operators doing dry lab surgical manoeuvres performed equally well either with sequentially increasing latency or with full latency only, suggesting that both methods of training may be effective. Telesurgery can become a practical method of treatment. Within a few years, more widespread platforms and telecommunications may exist to launch everyday telesurgery procedures.
Telesurgery, telemedicine, robotics, surgery, latency, satellite, Internet, remote care
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