Slashdot Mirror
Canadian Surgeons Perform Telerobotic Surgery
AndroidCat writes "While the equipment used isn't new, this operation was different because one of surgeons was 400km away. Dr. Mehran Anvari in Hamilton Ontario tele-operated instruments in North Bay General Hospital, supervised by Dr. Craig McKinley on site. The link was over a high priority routed Bell Canada connection. The patient, Ms. Fortier is doing quite well. Don't try this from home with a dialup connection."
please : don't slashdot them while they are operating some people...
Trolling using another account since 2005.
We make the cut and...
Good thing they waited until after the operation to tell us about it. I'd hate for them to get Slashdotted in the middle of it.
"Sir, we are getting a 404 from your heart."
This gives new meaning to
NO CARRIER
I wonder if any of the special IP priorities that rarely get used outside of LANS (or in) were used.
Also, if any encryption was done, because id be concerned with achieving maximum latency possible.
They said over a commercial network, so I'd have to assume encryption, possibly with special hardware for it.
-- -- --
Help my mini cause: My journal
Is this what you call a telephone operator?
do you have color tv too?
"While the equipment used isn't new, this operation was different because one of surgeons was 400km away."
LAZY BASTARD!
Lots of folks complained about internet2, but this should be a prime example of why it is important.
Just last week, we had a drop out of the Abilene node and most traffic from our lab was routed onto commodity routes where the performance degredation in terms of bandwidth and latency was pretty noticeable. I have become used to the gigabit ethernet performance in my dual G4 and degradation in performance with it due to Internet2 downtime is frustrating.
Visit Jonesblog and say hello.
WTF: used in slashdot sucks Ontario??? Checking if the mods read your comments?
My primary concern with this would be latency. Of course, disconnects are worse, but latency or perhaps a bad packet could result in some big problems during delicate procedures
Cheers, Joel
The surgeon just kicked your ass in Counter Strike with a 2ms ping.
Not today!
It's a good thing you weren't doing the surgery!
I think this has great potential. Some operations can only be done by a select group of surgeons, this technology makes it possible to perform operations that wouldn't normally be performed in a hospital. I think this is going the save lives on the long run. Let's just hope they don't run Windows, I wouldn't like a crash when I'm on the table.
Sooner or later, an operation like this is going to fail. When questioned, the doctor will respond, "omfg!!!!! fucken lag!!!!!"
ö SignOff Mehran: #operating-room (Ping timeout)
<Craig> Oh shit!
Telerobotic Surgery for Dummies
We already use micro-manipulators to do things so fine that we humans find it hard to control our own hands to do. There are many things a machine just does much better than we can.. things like zoom vision, ability to see from angles where we can not get our heads to, and doing precision tasks. Ever tried to make stitches as precise as a sewing machine?
The business end of the machines can be much smaller than our fingers, and tools on the machine are designed expressly for needed things. None of this "hand me the scapel, nurse" stuff. The machine can have as many arms and tools as the designers deem necessary.
And the machines can be made absolutely sterile. It is really hard to sterilize a human, and still have us functional.
It is really a tiny, very tiny, step from going to having a surgeon sitting next to a patient doing the surgery, to having one on the other side of the world doing it... ( the main problem is latency ).
The biggest advantage to the patient is that his need of surgical services may happen at any time - what it means is there is a world-wide pool of surgeons available to help - right now. They do not need to get scrubbed. If they are a critical care surgeon, by golly, they may have their end right in their den at their personal residence. Even if the surgeon was in a most unsanitary condition at the time of need, that would not be a factor. Time is. And that is what this technology gives us. Who is best equipped to meet the need... NOW.
This is what dreams are made of. This is why we go to work. To make things like this.
This is why we need technology.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
I had this done to me. Well, something similar. The only problem is that I went under as a man and I woke up as a woman. Everyone was rather confused as to what happened, but in the end they didn't charge me any extra and I've become pretty happy with the results.
No link, no matter how fast or secure, will let a physician monitor the status of his patient nearly as much as actually being there. I could do my job from remote at home, but my boss prefers I actually come in to work, in case something goes wrong I can be there first hand to see what's going wrong.
It's not like 400km is a great divide. Drive it. fly it. Okay, the operation was a success, but say it wasn't. The first question that's going to be asked is, "and you decided to perform the operation from beside your swimming pool watching it on your 14" TFT why?"
I'm not surprised this is possible, nor would I bother with the risk. What do we need airplane pilots or taxi drivers for, if these jobs can ben done by someone sitting behind a console or in a cafe. Hell, someone could fly two planes at once.
Get my drift?
... if we can perform surgery via telerobotics, why wouldn't we be able to perform, say, guided experiments in space?
... of course, we'd have to deal with staying in contact with the shuttle while it orbited the Earth, and the lag associated with such distances ... and it wouldn't be quite so exciting ...
Given the inherent safety issues with routine space travel, how difficult would it be to create a remotely manned orbiter to carry out space based experiments?
It seems like there would be a tremendous number of benefits -- no direct risk to human life, smaller shuttle / more room for payloads, 24/7 operation (split shifts behind the controls), etc.
Just a thought. Any ideas?
This is probably the killer app. Being a med student myself (and having just watched Scrubs) I think the ability to have someone watching over your shoulder during an important operation would greatly assist confidence during learning surgical procedures -- especially during unusual times of the morning when the hospital is understaffed etc., and you're the house surgeon lumped with everyone walking in the door.
However, allowing dangerous operations to be undertaken in remote locations is probably not a great idea... without qualified staff physically on hand, I don't think you'd want to trust someone's life to an IP connection; otherwise, the next time some DDoS or Outlook worm strikes, servers aren't the only thing we lose.
More like he'd been slammed for malpractice at some point in the past, and they wouldn't let him in the country...he had to dail ld
Don't worry about it happening on a regular basis tho...by the time tele-surgery gains momentum, it will be fully robotic and 99% non-invasive.
By David Orenstein, December 2001 Issue
Earlier this fall, 68-year-old Madeleine Schaal volunteered to make medical history by allowing Jacques Marescaux and Michel Gagner to remove her gall bladder. What's so unusual about that? Only that she lay on an operating table in her hometown of Strasbourg, France, while the two doctors performing the surgery were in New York.
I don't think latency would be such a big deal. It would be rather simple to write some sync code. That way the surgery might lag, but at least the surgeon's movements would never be ahead of the operation itself. His commands could be ignored until the two ends were in sync again.
killer app? Excuse me? They're teaching med students to kill, these days, are they?
Man, no wonder malpractice is out of hand.
And being rabid is no excuse.
You are not supposed to publish the patient's name.
Medical treatment is confidential, even over Internet links
Best case: surgery is fine, patient recovers.
Worst case: link gets disrupted, surgery machine goes Max Headroom on the patient -- "sl-sl-sl-sl-slice!!"
evil adrian
Obligitory bad joke: "So would all operations be done calling collect?"
All I ever wanted was an honest week's pay for an honest day's work.
The cool thing about the Canadian health care system is that ANY citizen can get free Internet surgery!
evil adrian
How does 70% funny and 30% overrated = +1
:(
I just don't get it.
LOL
evil adrian
That was hilarious! Normally I can't stand slashdot trolls because they're very stupid, but this was actually funny.
Like what I said? You might like my music
I don't want MS to be a part of it. Their prime aim seems to be to prevent anyone from truly innovating. I'd even suggest we pay MS to stay off Internet2 - say something like $10bn.
If you keep throwing chairs, one day you'll break windows....
BUHAHAHAHAHA
If you live more than 5km from anywhere, you certainly aren't high priority to Bell. I should know, I used to work for them.
I would expect such blatant racism on Fark, but on Slashdot? Mods please ban this asshole.
Wait a minute...it's not like there was a lady on an operating table, being prodded by a robot and no-one around save perhaps a pimply-faced computer geek to make sure everything was going well. There WAS a doctor overseeing events at the site. Conversely, it's not like the doctor on the other end was lounging by the pool, tweaking the trackpoint of his IBM ThinkPad. This technology wouldn't be used on a person unless it was proven safe and the benefits for outweighed possible risks (also, remember they weren't doing brain surgery on their maiden voyage--it was surgery to correct an acid-reflux problem, so if there were problems the risk of death would be quite low).
You're right--400 km isn't exactly a cross-continent trek, but keep in mind that a round trip by car would eat up eight hours of a skilled surgeon's time (and time is money), and even flying would take a few hours. Also, remember the surgery was in North Bay and performed by a doctor in Hamilton. North Bay isn't exacly a metropolitan hub--there's maybe what...50,000 people there? I don't think there are gonna be direct flights leaving hourly from Hamilton. Besides, do you know what the weather has been like in Ontario lately? Cold and horrible! Flight schedules aren't going to be reliable, and driving 400 km through a blizzard would be quite treacherous!
The next step is to start using this technology in places like Yellowknife. Yellowknife! Not exactly the kind of place that's teeming with specialised surgeons, and a doctor in Toronto can't easily hop a train, plane or taxi there, nor can the patient be safely relocated to Toronto without great expense and risk. You'd have to hop a 727 in Toronto to Edmonton, a lear jet to Ft. McMurray and a turboprop to Yellowknife (at best you might be able to avoid the stopover in Ft. McMurray)--or else spend a great deal of taxpayer's money in an already strained socialised haelthcare system on a special private direct flight.
Yup, telesurgery starts to look pretty appealing if you've been suffering on a long waiting list typical of the healthcare system in Canada, and it offers you the chance to get it done not only properly, but much sooner as well.
And if we put a taxi driver out of a job who the hell cares--he's probably an immigrant with 10 years of medical training and a long history of performing surgery in Pakistan, scaping out a living until all the immigration bullshit has been shoveled and he can get certified to work as a doctor in Canada. Maybe the money saved with this technology can make that process go faster so he can "do surgery by the pool" with Dr. Anvari. That old farmer in Cowcrap, Saskatchewan who needs his hernia fixed might appreciate the resulting shorter waiting time too...
with this perverse investment in technology it brings to light the possibility of murder by Virus.
Hack a machine being prepared for the surgery and have it send a horizontal slice 30 minutes into Mr. Gates open heart surgery.
There is no stopping this kind of crime unless the computers involved are Bios flashed, loaded from ROM media(from a locked and certified source), and tested immediately before the procedure. quite like putting all your physical devices in an autoclave.
I like tech, but I'll stick to live docs for a while, or get it done quickly before this type of crime comes to surface.
THE WORLD IS GOING TO END!!!! eventually.
I would imagine that they start off with low-risk operations now, as a form of practicing, as it were. No doubt they also have a backup team of surgeons ready to intervene if something threatens to go wrong. Besides, I do not expect that they will be remotely doing life-or-death or really invasive surgery for a long time, if ever.
There is also the matter of using robots and remote-controlled scalpels and the like for brain surgery; in these cases I am quite sure this is controlled by the surgeon located right there with the patient.
SIGBUS @ NO-07.308
Ya, my grandpa is doing this right now as we speak. you can monitor it realtime as he gets his new heart. here's his URL: http://grandpasheartmonitor.com
Grandpa? GRANDPA???? *BEEEEEEEEEEEEEEEEEEEEE........
THE WORLD IS GOING TO END!!!! eventually.
400km is nice, but how about New York to Strasbourg, France, 2 years ago, using the same Zeus robot ?
Unfortunately it was drowned under the 9/11 news at the time.
Google for "Operation Lindbergh"
Poor docs, now they'll have to carry Medical DoS Insurance...
Karma whorin' since 1999
Oddly enough, this got little or no press at all about this, until the actual procedure occured. Sadly, it wasn't even the big news story on our LOCAL news channel...they didn't even play it first during our local news. This is a groundbreaking operation which could lead to people gaining access to skilled surgeons around the world.
Defender of Microsoft and Communism!!!
as a surgeon, i have my misgivings about these types of surgery. the easy surguries a 4th year medical student can do. the hard ones are what we get paid for. laparoscopic surgery can have severe complications, like poking a big vessel called the AORTA. you need someone who can open up a patient and stop the bleeding RIGHT AWAY. there are times when you just can't use laparoscopy also, and you need actual feel. cost-wise, it may be cheaper buy a bus ticket for the patient to get the consultation 400 km away, than for every hospital in the country to have these robots in the OR.
Supreme executive power derives from a mandate from the masses, not from some farcical aquatic ceremony.
LOL you actually wasted a mod point on this??
I guess this is what is meant by having putting someone's Life on the LINE.
In his classic 1946 novel "City" Clifford Simak predicted the fall of the city as the focal point of human life and interaction. Telecomunications and globally networked computers were going allow people to live anywhere, and work from wherever that was, over the network, creating a dispersed culture with minimal "face time" in people's lives.
Independant robots with artificial intelligence were, of course, a major part of that invisioned future, taking over the tasks of housemaid and gardener, thus further reducing the overall level of interhuman interaction. ( Can you say automatic vacuum cleaner? I knew you could)
Truely visionary. In 1946 the American suburb and "planned community", as we know it, was still a gleam in the Levitt's eyes. Computers themselves were the crude and expensive dinosaurs of geek myth and networks didn't exist, let alone anything on the scale of the internet.
What makes all of this relevant to the article is that Simak predicted one of the side effects of this would be an increasing social isolation of humanity, to the point where we were actually unable to deal with each other face to face, or even leave our homes with any comfort. To an extent the evidence suggests that there is a certain truth to this and all of us here are well familiar with the stereotype of the net connected and sophisticated geek huddling in some dark hole somewhere (like his mother's basement) but essentially inept at face to face confrontation.
To illustrate this he chose to tell the story of a supremely gifted surgeon who allowed a friend to die, a friend with the answer to life, the universe and everything ( as yet unrevealed to the public), simply because his isolationist produced agoraphobia didn't allow him to travel to perform the needed surgery.
Simak's prescience in this novel is absolutely stunning in scope ( and the story is masterful as well, read it), but the one thing he did not forsee was that even *surgery* would one day be performed from our isolated aeries in the Himalayas ( well, to be fair, he did actually take this partially into account by placing the surgeon on Earth and the patient on Mars, thus net lag was a significant factor in the requirement that the surgeon actually be *present* on Mars, but we can already forsee ways around this problem).
Perhaps only our geometrically increasing numbers stand between us and his vision of an isolated future lived over the net.
KFG
the Blue screen of death will be the red screen of death after "where will you start today"
Too many people think something is going to go wrong. As long as it's not done on windows, fine by me. Though it would take BSOD to a new level.
I'm wondering if you took 19 minutes to post your first rant, and then went straight on into this one or was there a break in-between posts?
:)
Just interested.
Oh yeah, you quitting smoking at the moment? Cause thats just how I feel
I want to release a brown torrent of liquidy pasty brown paint like shit into your face, whaddya think of that assfuck?
The only logical combination would be remote-sex and telerobotic masturbation...
Actually, on the point of telerobotic-sex. How about telerobotic cooking? so maybe my mom can cook me an omlete that I can't get so often, since I live some 8000 miles away? Or have famous french chefs cook you some *real* french dinner? Or, heck, have the shit on Iron Chef telerobotically cooked in your local telerobotic restaurant / community food-center, so we can taste, and not just dool over, the fine ass dishes they make on the show? I'd pay some serious cash for the food network to be broadcasting such kinds of data. I wouldn't think it's difficult to record it and have the same meal prepared when you need that exotic whatever to save your life (say, when you get the munchies, or your pregnant wife gets the cravings, etc). Still have to buy the ingredients though...
My life in the land of the rising sun.
Um, no it wasn't hilarious.
No one cares that you are dumb.
A recent report in German magazin DER SPIEGEL indicates that hip bone operations performed by "robodoc" surgeons still have a high rate of failure.
Robodoc is only an example, the report's main focus is that US regulations for medical procedures require more safety testing than German regulations. As a result, German clinics are a testbed for new, untested technology from abroad, sometimes with chilling results.
German clinics already use Robodoc for hip bone operations on a quasi-regular basis (the report estimates 10000 operations in Germany so far) while the same procedure still hasn't been in approved in the US by the FDA since 1993.
The report quotes critics who see a blind faith in technology, patients are told that Robodoc is far more exact than any human operator, while there are still a number of embarassing failures.
------------------
You may like my a cappella music
Just need to remove the tissue here... ...
Why have you stopped?
Damn X10 popups!
Should I continue the operation?
No...I think I got it...
Everyone heasrs, muffled in the background, a high pitched voice saying, "Uh oh".
What was that?
FUCK! Who left ICQ running!
Is there a problem?
No...let me just...
Are you there? Hello?
It is that point that "Blue screen of death" takes on an ominous tone...
a robot system for remote tiling and grouting for a space shuttle wing?
If I reply on the topic of an off topic post am I off topic or on topic?
Dad the saw-bones would still have to quit his sailing race or golf game to fix the broken motorcyclist. But at least he could travel to the nearest metropolitan hospital instead of the outback to do it. Oh curses, I know he would prefer the excuse to go outback. But these days it is cheaper to plug the holes and bring them back in helicopters or planes, just like MASH.
-- it must be true, it's on the internet.
Wheeee! Sorry, I had to. I am now batting .100 on submissions, f34r me! :^)
One line blog. I hear that they're called Twitters now.
The actual point is that there are very peculiar operations that only a few surgeons in the world are able and willing to perform; e.g. the seperation of twins conjoined at their heads. Now compare flying them around from continent to continent to having them stay at home, where they could still be able to do the same job.
Of course it would be nice for our Chinese friend if someone set up a whole operating room in his home, but this is still science fiction. Flying him over to a nearby hospital on the mainland (or another island, wherever the nearest one is) and promptly starting the operation would still be an huge improvement over having him to transport to Beijing or having to wait days for a surgeon.
but what do i know, i'm just a model.
I remember 2 years ago, US (NYC) and France (Strasbourg) did a cross atlantic surgery intervention (Much much more than 400km ). Here is the clue : Stanford Article.
The lady that had the pleasure of being one of the first, is my wife's sisters Mother inlaw. We didn't know that had taken place until we were watching the news last night and saw here, at first it was 'man she looks like someone I've seen before" then when they subtitled her name it was all to clear
She's been contact by 60mins as well, not sure if she's going to do it.
From the article...
...via Bell Canada's Virtual Private Network Enterprise (VPNe)system. Bell's VPNe uses Cisco Multiprotocol Label Switching technology to allow private networks to be created out of Bell's national IP structure.
How sweet will this be for Cisco marketing? But seriously, a properly designed MPLS network would be great for this. Congestion? Drop/delay all that !&#@(!* Kazaa traffic from those hardly profitable home DSL users in other classes.
As an aside, this will help usher in an era where engineers in the comms/networking/internet fields can once again see need and value for membership in professional engineering organizations, such as the PEO in Ontario. You don't want someone that only has a knack for networking to setup this type of environment. You want someone with the knack, the theoretical education, sufficient experience, AND legal liability for their design and implementation to pull this off.
Now, if only I could get to sending in my EIT papers...
... I'm thinking line noise would be bad...
;)
"Ok, now I'm going to make a sub dermal incision just below the @$_+*)SDF+_*&S+D*YF}H @#$*Y *YQEF"
DISCONNECTED
Just gotta hope none of the line noise is a valid sequence?
Shadus
I wonder which plan they were on? Bell has capped downloads, and I think these docs may have broken records.
The new Ontario health care system
I figure it won't be long now until porn sites are offering remote robotic wanking machines. It would be the next logical step.
Biotech means modifyng DNA (usually bacterial DNA) to get a product or a service. In Slashdot, biotech seems to be everithing related with medicine and high tech.
According to the Utexas.edu life science dictionary:
Biotechnology
Definition:
The industrial use of living organisms or biological techniques developed through basic research. Biotechnology products include antibiotics, insulin, interferon, recombinant DNA, and techniques such as waste recycling.
Much older forms of biotechnology include breadmaking, cheesemaking and brewing wine and beer.
DNA in your Linux: DNALinux
Thank you for raising the level of discourse.
my liver's been hax0red!!!!!!1111oneoneone
The wise follow a damned path, for to know is to be forsaken.
Ok, I know that one of the main goals of ISS is to learn how to create a life-supporting space abitat ... but maybe is time to rethink about it.
Ciao
----
FB
Dr. Mehran Anvari in Hamilton Ontario tele-operated instruments in North Bay General Hospital,
You'd think that Dr.Anvari would take whatever chance he could get to get out of Hamilton. People here know it as the armpit of Canada.
This is left as an exercise for the reader.
I can see it now - insurance companies are going to push operations to offshore, Doctors in Bangalore are going to be operating on American patients using telesurgery.
Brings a whole new meaning to BSOD...
Two year a go an equipe of University of Montreal to the same thing 6000 km away on a patient in Lyon France.
Ceci n'est pas une Signature !
Lassie dials in with a 56kbps connection, performs the operation and saves the day. Good dog!
Yeah, you gotta have *at least* a 256K DSL line. Otherwise DIY home robotic surgery could be problematic.
There are 01 kinds of cars in the world. The General Lee, and everything else.
Tactile feedback and 3D vision.
If the surgeon can not feel when the instrument touches the organ or encounters an obstruction, how can he operate at all?
3D vision is important, too. Or, even better, an ability to move the camera, controlled by his head movements - ability to look at the field from different angles. Then the surgeon's brain can restore the 3D picture of the field.
There has been much discussion already about how the justice system is pretty skewed in its handing of malicious crackers (in the US, at least... I haven't heard much about crackers in Canada).
There's the Mitnick example, of course, where it really seems like he was not punished commensurate to the damage he actually caused. Basically, a lot of people were scared about the *money* that could have been lost due to his activities.
Now imagine if lives are on the line. Never mind sales lost, imagine lives that could be lost due to DDOS, or even a security hole in the servers managing the surgery (imagine someone poking their way through a system they stumbled across with all *kinds* of interesting, unfamiliar stuff on it... and suddenly the laser scalpel starts heading north).
There are only 10 types of people: those who understand decimal, those who don't, and, uh, 8 other types I forget.
Indeed, read Clarke's "A Meeting with Medusa" to see why.
Usually the vulnerability is in the last mile where all the redundancy, multi-routes would not help.
so does this mean doctors will be making house calls again? only it's the other way around.
MoRe... LaTeR... -=PJK=-
CBC radio will be (is) having a short bit on the operation. (12:32 est Probably it can be time-surfed at CBC Radio
One line blog. I hear that they're called Twitters now.
"Waldo! There, I've said that!"
Sterelizing instruments is relatively easy, as they're small individual pieces. But how would they sterelize the whole robot, or at least its hands?
Are there some kind of latex gloves it is first covered with, before the operation?
-kidlinux.
The USA doesn't need Canada's help in making the ISS a total piece of crap--but thanks anyway for that worthless thing. I hope you have different people working on the robotic arms that do surgery.
Hand-eye coordination is a 100-500 millisecond feedback loop.
This waldo probably added all of 40 ms to that, if they had a clean link.
I lost con and died. That sucked.
Doctor: [on TV] ...and then, you make the incision below the collarbone.[splurt]
Dr. Nick: Oh, no. Blood!
[The screen then fritzes into a cheezy talk show.]
Dr. Nick: Oh, no, someone taped over the end of this!
Just say that something happens to the paitent during the operation and it is the surgeons fault..
for arguments sake say the surgeon is in New york, and the paitent in paris.
which country's laws apply to the case?
france? becuse the paitent is there and being operated on there.
or america? because the surgeon is actualyl there,a dn operating from there???
The good news is that when you want to brand your initials on the patients' internal organs, you can design something really cool in your CAD program, then upload and let the robot tag that kidney so it looks real nice. The bad news is that it's not as much fun to fondle that unconscious hottie any more.
The universe, they said, depended for its operation on the balance of four
forces which they identified as charm, persuasion, uncertainty and
bloody-mindedness.
-- Terry Pratchett, "The Light Fantastic"
- this post brought to you by the Automated Last Post Generator...