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Gall Bladder Removed In France By Doctor In New York

cybaea writes: "In this article, the BBC reports on the first successful major telesurgical operation. Doctors in the United States removed a gall bladder from a patient in eastern France by remotely operating a surgical robot arm." Note that this was using a "high speed optical link," not competing with email, viruses, or other things being sent on the Internet. Update: 09/19 17:05 PM GMT by T : Uh, that's "gall bladder," not "tumor." From this distance they look the same to me.

46 of 206 comments (clear)

  1. Tumor != Gall Bladder by Capt_Troy · · Score: 2

    I think this is funny. There is no mention of a Tumor in the article or the submitters comments, yet it appears as a headline. A gall bladder is an organ, not a tumor.

    1. Re:Tumor != Gall Bladder by fobbman · · Score: 5, Funny

      Overheard in the surgeon's office in New York:

      Doctor: Damn, I was supposed to remove a tumor?

    2. Re:Tumor != Gall Bladder by kilgore_47 · · Score: 3, Informative

      (from the BBC article)
      The procedure could make it possible for a surgeon to perform an operation on a patient anywhere in the world.

      Sure... anywhere in the world equipped with a surgery-performing-robot, a secure guarenteed-to-be-up data line, and a team of backup doctors in case anything goes wrong.

      --
      ___
      The way to see by faith is to shut the eye of reason. --Ben Franklin
    3. Re:Tumor != Gall Bladder by realdpk · · Score: 3, Funny

      The procedure could make it possible for a surgeon to perform an operation on a patient anywhere in the world.

      and here we are worrying about whether or not the govt will be able to open our *emails*...

  2. I heard... by Rude+Turnip · · Score: 4, Funny

    that the surgeon yelled out "First Incision!"

  3. So... by tshak · · Score: 2

    If someone performs a DDOS on a lot of major POPs PNAPs and it inturrupts communication and kills the patient is the script kiddie up for murder?

    --

    There is no longer anything that can be done with computers that is nontrivial and clearly legal. -- Paul Phillips
  4. Ouch by SilentChris · · Score: 3, Funny
    "by remotely operating a surgical robot arm"

    Boy, a buffer overflow during that would be a bitch.

    1. Re:Ouch by fobbman · · Score: 5, Funny

      A tragedy was narrowly averted when the surgeon was in the middle of an intricate micro-stitching and a casino pop-up ad obstructed his view. Thank goodness a forward-thinking assisting had their hand on the mouse ready to "X" it outta there.

    2. Re:Ouch by kilgore_47 · · Score: 2

      Seriously, I have to doubt the usefullness. A robotic arm with remote control options can't be cheap, and if I were on the table I'd much rather the doctor just hopped on a plane and came to me.

      The idea of having the cameras in place so doctors could watch (and discuss) live surgery in far away places would be cool. But c'mon, a robotic arm doing surgery?

      It just doesn't seem like this is a good use of money, especially when you account for the extra risk to the patient.

      --
      ___
      The way to see by faith is to shut the eye of reason. --Ben Franklin
    3. Re:Ouch by znu · · Score: 2

      This probably isn't such a big deal for routine things, but there are some cases where there are just a small handful of doctors who can perform a certain procedure properly. They can't spend all their time flying around the world, and the patients aren't always in good traveling condition. Once this technology reaches maturity, you'll be able to get treatment from any specialist you need at any hospital. Remember, these machines will keep getting cheaper. Doctors, if anything, get more expensive.

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    4. Re:Ouch by NMerriam · · Score: 2

      The robots will be in the $100k range (currently much more) within years, and a plane ticket to Europe at the last minute would cost $2-3k at a minimum. factor in the time, and the possibly critical state of the patient, and you can cover the expenses with a dozen patients...

      --
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    5. Re:Ouch by tmark · · Score: 2

      I don't question the usefulness. I *do* question how judicious the doctors were in performing the demonstration. This procedure was almost certainly not a life-or-death one that could only be performed by specific doctors in the U.S. So performing it in this fashion *must* have exposed this patient to some risks, even if there were qualified doctors on the patient's side of the ocean overseeing the work, else this story would not be newsworthy. The doctors therefore exposed a patient to some risk just for a proof-of-concept, a publication, and a lot of P.R., when the proof-of-concept could have been done by operating on a pig, or just demonstrating the requisite dexterity in some other fashion. I guess this is just another case where the vanity of surgeons conflicted and overrode the safety and interest of the patient involved. What would the press release have looked like if the patient had died, I wonder.

    6. Re:Ouch by krlynch · · Score: 2

      Well, I haven't read the article so I may be mentioning something that was mentioned in it, but those things you suggest doing first (operating on animals and proving dexterity through some other experiment) HAVE already been done... that's why it was not unreasonable to do this on a real live patient with a condition that was not difficult to treat (i.e. a condition that any surgeon could perform, and which was not a technically demanding operation). I mean, you wouldn't want this being done on a patient that needed microsurgery or a heart transplant as your first trial.

    7. Re:Ouch by krlynch · · Score: 3, Insightful

      One eventual goals (and one of the reasons that the USDOD is paying big bucks for this kind of research) is to send these types of systems into "dangerous" areas where you wouldn't want to risk the safety of a specialist, or can't afford to send a specialist (major natural disasters, military campaigns, space explorations, remote research stations, etc.). It is unlikely that you will see many more gall bladder removals done in the middle of France with this technology. But you ARE likely to see, for example, soldiers patched up very close to the battle field, or researchers having cancer surgery done in the depths of the Antarctic winter when it is just too dangerous to try and either fly the patient out or the doctor in.

    8. Re:Ouch by Fjord · · Score: 2
      I'll even up the ante on that one then and say that eventually this will lower the cost of doctors as cheaper, but still quality surgeons from other countries can perform operations.


      Of course, knowing the insurance industry, HMOs eventually won't cover your operation unless it is from a cheap country.

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      -no broken link
    9. Re:Ouch by Fjord · · Score: 2

      I'm sure the patient was informed of and elected to go through with the risks of this procedure. Some people, myself included, are willing to take some risks in order to advance science, especially medical science. I am also doubtful that they haven't already done animal experimentation with this device.

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      -no broken link
  5. Telecommuters by spudnic · · Score: 2, Funny

    I can just hear all the surgeons begging their bosses to let them telecommute from home now.

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    load "linux",8,1
  6. Better Picture of Robot in action by FortKnox · · Score: 4, Informative

    Here's a pic of the robot in action. Looks like that gall bladder was pretty big, or the frenchwoman isn't what I'd call "underweight".

    Notice the three large arms sticking in? Gall Bladder surgery is usually arthroscopic. So, long distance surgery does have the drawback of more/bigger scars.

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    1. Re:Better Picture of Robot in action by Cy+Guy · · Score: 2

      Also note that doctors and nurses in the background aren't wearing surgical gloves. Maybe there are gloved surgeons standing by, but this pic gave me the impression that had the robot malfunctioned (perhaps due to a power failure) the surgeons would first have to scrub and get gloved-up before jumping in to help the patient.

      As to the aparent weight of the patient, I think its more likely that the patient was pumped up with CO2 which is typical for laparoscopic gall bladder surgery.

    2. Re:Better Picture of Robot in action by sharkey · · Score: 2

      ...arthroscopic...that means scoping a joint....most gallbladders aren't found inside joints

      Maybe that's why she had to have it taken out?

      --

      --
      "Outlook not so good." That magic 8-ball knows everything! I'll ask about Exchange Server next.
  7. Pointless by LordNimon · · Score: 3, Insightful
    I thought the whole point behind going to a specific doctor for a procedure was that he's far more knowledgeable about it than anyone nearby. Removing a gall bladder isn't exactly cutting-edge medicine.

    But I would never go for this. Part of the advantage of having such a capable physician is that if anything goes wrong, he can take care of it. The robot arms restrict his options and make it more difficult to work in an emergency.

    Not only that, but this involves a reliable high-speed connection. The only time this technology would be truly useful is if you were in the middle of nowhere and needed an operation. But if you're in the middle of nowhere, you'll never be able to get a reliable high-speed connection!

    --
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    1. Re:Pointless by 13013dobbs · · Score: 2
      I thought the whole point behind going to a specific doctor for a procedure was that he's far more knowledgeable about it than anyone nearby. Removing a gall bladder isn't exactly cutting-edge medicine.

      Seeing how this is the first time this kind of thing has been done, I think that is why they chose a simple operation. Removing a gall bladder is easy and rarely fatal.


      But I would never go for this. Part of the advantage of having such a capable physician is that if anything goes wrong, he can take care of it. The robot arms restrict his options and make it more difficult to work in an emergency.

      There are other surgeons in the room in case something did go wrong. It is not as if they just stuck the woman in a machine and then went out for coffee.


      Not only that, but this involves a reliable high-speed connection. The only time this technology would be truly useful is if you were in the middle of nowhere and needed an operation. But if you're in the middle of nowhere, you'll never be able to get a reliable high-speed connection!

      There are highly specialized surgeons that are not available in every country, even in technologicly advanced ones. Once all the bugs are worked out, which might be decades from now, these surgeons will be available to anyone. Also, with any luck, high speed connections will be much more commonplace, even in remote areas.

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    2. Re:Pointless by 13013dobbs · · Score: 2

      I don't mean to downplay the significance of this event, but in reality it will be cheaper to fly the doctor to the patient, no matter how remote the area, than to lay (or probably even use) fiber, for a long, long time.

      True. But then a doctor could only do 2-3 operations a week, if you consider travel time, jet lag, and all that. But, with this a doctor could operate on some one in South Carolina on Monday, Germany on Tuesday, and Vietnam on Wendsday.

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  8. Actually by brianvan · · Score: 2

    They were probably competing with viruses of both kinds. You really have to have a sterile environment both over the network and in the operating room.

    More bizarre thoughts:
    Will doctors sue for carpal tunnel? Will doctors sue for carpal tunnel after performing remote surgeries on carpal tunnel patients? (The ultimate in irony)

    Can doctors now prescribe medication remotely? And if so, can I just buy 10 different masks and walk in with each saying "Yea, 100 Vicodin to go please..."

    Do the robot arms have bad handwriting as well?

    Will the nurses now look like Seven of Nine and give me sponge baths?

    Will dentist robots be bugging me now about how bad my brushing habits are, even though I never have cavities?

    And finally, will all the script kiddies be hacking into those remote boob-job surgeries? I hope they get grossed out and short circuit their 31337 keyboards with vomit, cause it's not for the squeamish.

  9. otehr uses.... by jeffy124 · · Score: 2

    This surgery should be encouraging news for NASA.

    They're is doing research along this same theme. They someday want robots to be able to be controlled either from the ground or the space station by a person wearing a VR suit. The human can see a 3d image of what the robot is working on and they're working on having the bot transmit some kind of feel (a sense of touch) back to the human. Advantage to this is the ability to make the robot fit into small or dangerous areas and not subjecting a live person to danger.

    --
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  10. modify DoomPS by 13013dobbs · · Score: 2

    Just modify the version of Doom that allows you to kill processes and you can do both.

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  11. Apply all patches before operation! by KarmaBlackballed · · Score: 2

    Make sure the tech team at your local French hospital apply all patches to the communication software or else you might get operated on by a script kiddie from China.

    I don't care what internet this runs through, I want a real doctor in the room with me.

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    --- -- - -
    Give me LIBERTY, or give me a check.
  12. medical transcript... by turbine216 · · Score: 5, Funny
    here's the just-released transcription of the communciations between the surgeon and the patient:



    DOCTOR: how r j00 feeling?

    PATIENT: ok

    DOCTOR: duz this hurt?

    PATIENT: ouch

    DOCTOR: roflmao

    PATIENT: :(

    (PATIENT signed off at 08:36 AM EST)

    DOCTOR: hello?

    DOCTOR: r u there?

    DOCTOR: kewl
    (DOCTOR signed off at 08:38 AM EST)

    1. Re:medical transcript... by abe+ferlman · · Score: 2

      w0w, wot a 7337 rx0r!

      --
      microsoftword.mp3 - it doesn't care that they're not words...
  13. Re:Since when is a Gall Bladder a Tumor? by kilgore_47 · · Score: 2

    So if they foul up halfway through, is there one doctor who says "hey guys lets try that again! I only fucked up cuz of lag, d00d!"?

    --
    ___
    The way to see by faith is to shut the eye of reason. --Ben Franklin
  14. Dirty old men by Rosco+P.+Coltrane · · Score: 2

    Americans would do anything do get to know French women more intimately ...

    --
    "A door is what a dog is perpetually on the wrong side of" - Ogden Nash
  15. Lag by Reality+Master+101 · · Score: 3, Informative

    If you figure 3000 miles both ways, then we're talking a minimum 0.03 seconds of lag. When you figure all the overhead, plus you don't get perfect speed, that could be a 0.1 seconds. That seems pretty significant if you are doing delicate surgery. It would be even worse if it was across the world.

    As John Carmack once said, "The speed of light sucks".

    --
    Sometimes it's best to just let stupid people be stupid.
  16. "From this distance they look the same to me.." by Wakko+Warner · · Score: 2

    ...good thing you're not the surgeon then.

    - A.P.

    --
    "Remember when the U.S. had a drug problem, and then we declared a War On Drugs, and now you can't buy drugs anymore?"
  17. Highspeed optical link by rjamestaylor · · Score: 2
    Note that this was using a "high speed optical link," not competing with email, viruses, or other things being sent on the Internet.
    Other "things" being Code Red, Code Red ][, Code Blue, Nimda, and other features of MS IIS...

    It would be nice for critical applications, such as surgery, critical teleconferencing, ... downloading KDE 2.X..., to pay a couple bucks (X 10) and be on a dedicated route to the other end. Over the Internet, I mean. For the vast majority of Internet usage the passive routing is fine but for a small percentage, it is too happenstance to be trusted. What would it take (besides Internet][, I mean) to have a dedicated route option?

    --
    -- @rjamestaylor on Ello
  18. Speech recognition by ph117 · · Score: 2, Funny
    The robot responds to verbal commands like ``move up'' or ''move down''

    I sure hope it's more accurate than some of the speech recognition tools I've used.

    • Doctor: "Move up"
    • Robot: "COMMAND NOT RECOGNISED"
    • Doctor: (clears throat) "Moooovvvveee up"
    • Robot: "COMMAND NOT RECOGNISED"
    • Doctor: "Moof up"
    • Robot: "COMMAND RECOGNISED: REMOVING GENITALS"
    • Doctor: "Oh crap."
  19. Wireless? by scott1853 · · Score: 3, Insightful

    This would be really good if they could setup the system in something the size of an ambulance so people can be fixed up without having to make them endure a helicopter or ambulance ride to the nearest hospital. So is 802.11 ready for this?

  20. Shouldn't that be a... by szcx · · Score: 3, Funny

    ... Gaul bladder?

  21. Ping? by UserChrisCanter4 · · Score: 2, Insightful

    It said in the article that the doctor was pulling a 200ms ping, and that the maximum acceptable latency was 330ms.

    Now I'm not trying to troll or be funny here, but that's a pretty lousy ping, especially for a direct fiber link.

    I don't know about anyone else, but Quake is damned near unplayable with a 330 ping. We're talking about life and death situations here... If I can't accurately rail someone with that kind of latency, I certainly wouldn't want to be trying to move my scalpel without knicking the femoral artery.

  22. Medical arrogance. by Rothfuss · · Score: 3, Interesting

    This is an absurd abuse of technology to further a doctor's career. There is no chance that this surgery was in the best interest of the 68 year old patient. Gall bladder surgery is reasonably common and could have been performed by any of a number of local doctors. This was *all* about getting a publication - which is sick. And I don't want to hear about how this technology will revolutionize anything, because the amount of logistical preparation needed on both sides will always make it easier to just fly a specialist to the scene and have her/him operate on the patient.

    The best quote from the article...

    "The time delay between the surgeon's movements and the return video image displayed on screen was less than 200 milliseconds. The estimated safe lag time is 330 ms."

    Estimated safe lag? As determined by who? The NIST? The AMA? Probably the doctor, immediately after hearing that the time delay was 200ms.

    -Rothfuss

  23. Maybe not that great by barzok · · Score: 2, Interesting

    I'll probably get modded off-topic here, but back in the QuakeWorld days, I got pretty good on dial-up. When I got a fat pipe (college LAN), it took me a couple weeks to regain that. I was so tuned into anticipating the moves and compensating for the lag that I had on a modem that without it, I looked like a spaz.

  24. Not the 1st time by macdaddy · · Score: 2

    This has already been done. IIRC open heart surgery was preformed on a guy in an Oriental country (I forget which) over the Internet2 by someone at KUMC (I believe it was KUMC). I saw that on Discovery this Spring. I don't have details for you. Hopefully that will be enough to find it yourself.

  25. Still important for other reasons by dimator · · Score: 2

    While the usefulness can be debated, it's breakthroughs like this that help restore faith in human beings, after witnessing the harm they can cause.

    --
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  26. Verbal commands and warnings by sharkey · · Score: 2

    ...can warn the medical team on the other side of the ocean if it was running out of surgical tape or other key materials.

    Duct tape can easily replace a empty surgical tape dispenser. Rubber cement, Swingline staplers and binder clips are pretty common, so the robot will be able to refill with the "next best thing" in case of a supply shortage.

    --

    --
    "Outlook not so good." That magic 8-ball knows everything! I'll ask about Exchange Server next.
  27. Remote control firefighters? by aozilla · · Score: 2

    Doctors in the United States removed a gall bladder from a patient in eastern France by remotely operating a surgical robot arm.

    What we need is remote control firefighters, that can enter burning buildings and put out fires from the safety of the command center a couple blocks away. A much harder problem, due to the necessity to climb stairs and all, but maybe you could make a helicopter version which could break through the upper story windows?

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  28. Legal Realities of Telemedicine - Not useful in US by billstewart · · Score: 2
    I'm in the ATM business (Asynchronous Transfer Mode, not Cash Machines, though we do them too), where Telemedicine has been a staple of hype vendors for decades. At least in the US, telemedicine is not realistic except for a few contrived situations, mainly because medical licensing is done on a state-by-state basis, at least for dramatic silly things like this. Usually anywhere that can afford robot doctors are high-tech enough big-city big hostpitals that have real doctors. There is a realistic case for remote support, which is a (human) doctor in one city where the patient is talking to a specialist in another city and sharing pictures back and forth. There may be emergency medicine situations where a paramedic needs to consult a specialist, but that's usually a wireless situation. If it weren't for the structure of the medical insurance systems dominating US medicine, there might also be applications for a nurse with a camera at a small office working with a doctor who's telecommuting from some other location, but the main situations where that makes sense are rural areas that don't have the right kind of doctor within an hour or two drive.

    (In a non-insurance-dominated free market, people could pay for what they wanted, which would probably include cost-effective non-bureaucratically-oriented structures like that. And in a socialized-medicine market, you'd probably have either lots of doctors, if you believe its proponents, or not enough money for experimental technology, if you believe its opponents, or less restriction on what the medical service can do as long as it saves the service money.)

    --

    Bill Stewart
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  29. I have 3 scars .... by taniwha · · Score: 2
    I had this same surgery last year, they go in through your navel and 2 other places, they also inflate your abdomen with dry nitrogen (I guess I must have looked like that :-), you have to walk a lot afterwards to help your body expell any that's left over



    It's the only surgery I've ever had and it was a breeze - I walked home within 24 hrs



    The fun part was when the doc removed the drain he'd left in a few days later - he said "this may feel a bit funny and it might hurt" - hit hurt like hell, but it felt ssooo wierd (all that stuff moving inside you as it came out) I couldn't stop laughing even though it hurt so much .... now I know how that guy felt in the 1st alien movie ....