Slashdot Mirror

← Back to Stories (view on slashdot.org)

Robotic Telesurgery by Remote Surgeons

Posted by ryuzaki0 on from the does-it-hurt-when-i-do-*this* dept.

Roland Piquepaille writes "In a few years, telesurgery performed by multi-armed robots remotely controlled by real surgeons located hundreds or thousands of kilometers away will become commonplace. Today, Canadian doctors from the Centre for Minimal Access Surgery (CMAS) are developing the technology for NASA. Their goal is to build a portable robotic unit that would be used in space missions, war zones and remote areas within five years. So far, the experiments already done in Canada and for NASA are extremely encouraging. But read more for additional details and pictures of a real surgeon controlling such a robot."

134 comments

  1. Problems? by mr-mafoo · · Score: 3, Funny

    "Oh no! The connection's lagging doctor!"

    "Reconfigure the upstream bandwidth, and re-route all traffic to the backup server!"

    1. Re:Problems? by IgLou · · Score: 3, Funny

      Better yet, make the robot surgeons web accessible.

      Nurse: "Doctor the robo-surgeon seems to have crashed."
      Doctor: "Look on the display it says, nothing for you to see? What's going on"
      In bursts the network admin exclaiming: "The surgeon he's been... slashdotted!"

      --

      Oops, how did this get here?
      09 F9 11 02 9D 74 E3 5B D8 41 56 C5 63 56 88 C0
    2. Re:Problems? by LiquidCoooled · · Score: 1

      Damn good job this demo isn't sponsored by Real.

      "As you can see, I make the incision here exposing the hear.....BUFFERING......

      --
      liqbase :: faster than paper
    3. Re:Problems? by Anonymous Coward · · Score: 1, Funny

      I heard the UK is about to pass a law that outlaws this sort of thing...

    4. Re:Problems? by grammar+fascist · · Score: 1

      "Oh no! The connection's lagging doctor!"

      "Reconfigure the upstream bandwidth, and re-route all traffic to the backup server!"

      That's a HUGE user interface problem, actually.

      The best round-trip time you'll get across the Atlantic is about 200ms. When you're expecting immediate feedback, it's an eternity. Not everyone learns how to deal with it very well.

      I'm the author of Unlagged for Quake 3 (which is currently the lag compensation technique used in Enemy Territory, if I'm understanding things correctly). It works by rolling back server frames and doing hit tests against the past. Too bad you can't do something like that in surgery!

      The best you could do is predict the robotic arm movement and show the predicted arm state to the doctor. Predicting the patient state? Good luck.

      And doctors have to do things that require a lot more precision than railing. Fortunately, they don't usually have a moving target.

      --
      I got my Linux laptop at System76.
    5. Re:Problems? by zyklone · · Score: 1

      You can do much better than 200ms across the atlantic.

      ~110ms between Sweden and New York right now for example. However it won't ever get much faster than that.

    6. Re:Problems? by Eivind · · Score: 1
      You can get a bit better than that.

      A quick check just now shows that I can, from western Norway, reach several servers in the US with ping-times of 100 -> 150 ms.

      Light moves 300.000 km/s and the distance from western Europe to eastern USA is on the order of 6000 km, so minimum physically possible pingtimes would be about 40ms.

      In practice, this means including the inevitable router-lag and the failure of network-cables to go in a straigth line, we're not likely to ever see much better ping-times than currently, 100ms or so is about as good as it gets, realistically speaking.

    7. Re:Problems? by Anonymous Coward · · Score: 0

      Damnit Jim, I'm a doctor not a network technician!

    8. Re:Problems? by x_MeRLiN_x · · Score: 0

      Being in London, I can get ~80 ms to New York.

    9. Re:Problems? by 1u3hr · · Score: 1
      That's a HUGE user interface problem, actually. The best round-trip time you'll get across the Atlantic is about 200ms.

      What the they thinking of when they talk about doing this in OUTER SPACE for God's sake? Where would it be sensible to do this? In low-earth orbit they should be able to de-orbit in a few hours in an emergency. Further out, near the moon it's 3 seconds round trip. En-route to Mars; forget it.

      Wait till they can build a Known-Space-style autodoc.

  2. A new thing you don't want to hear from your doc: by Cordath · · Score: 2, Funny

    Laaaaaag!

  3. Roland should at least make clear he's citing them by Anonymous Coward · · Score: 0

    FTA:

    In a few years, telesurgery performed by multi-armed robots remotely controlled by real surgeons located hundreds or thousands of kilometers away will become commonplace.

    Those are the article's words, not Roland's. Editors, please try to present some semblance of a care of not presenting stories when they aren't the submitter's own work.

  4. alien butt probe.. by Anonymous Coward · · Score: 0

    i thought the headline said real surgeons located hundreds of thousands of kilometers away as opposed to real surgeons located hundreds or thousands of kilometers away ..

    was getting worried aliens are now controlling us without having to bring their ufo's here due to high gas prices.

    -Sj53

    1. Re:alien butt probe.. by dhasenan · · Score: 1

      Even at 300,000km, you'd get a full second of lag. Do you want your doctor to lag that much?

      Or do the aliens control the surgeons using tachyons? Though that doesn't help asymptotically. (I'd like a log log(n) travelling algorithm, though.)

    2. Re:alien butt probe.. by Anonymous Coward · · Score: 0

      how would tachyon control change the lag. Info still travels at the speed of light. So at 300,000km you'd get two seconds between activating a scalpel motion and seeing it happen on your viewscreen.

  5. X-Bender by Tackhead · · Score: 1

    X-Bender: Fry: Stop being such a baby and chop my hands off!

  6. Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 4, Insightful

    ... QoS hooks are in and solid.

    This is a very strong argument for tiered bandwidth - so ISPs can guarantee that surgical waldo packets take priority over, say, downloads of the latest release of an OS or a new movie.

    It's one thing to hiccup when you're handling a VoIP packet. It's quite another when you're handling the content of a feedback loop including a video camera, a surgeon, a scalpel, and a vital organ.

    --
    Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    1. Re:Don't try that on the Internet until ... by Anonymous Coward · · Score: 0

      Isn't that What T1, OC3, etc. are for?

    2. Re:Don't try that on the Internet until ... by LiquidCoooled · · Score: 1

      Technically, it should be no different than driving the rovers on Mars.

      You take everything as a single indivisible step and don't rush until you know the outcome of the previous one.

      --
      liqbase :: faster than paper
    3. Re:Don't try that on the Internet until ... by shadowbearer · · Score: 1

      Well, since the unit is being developed to perform surgery in space, as well, I imagine they'll be using dedicated video/data links. There's no real mention of what exactly they will be using, but I'd bet that "advanced telecommunications technology" doesn't mean internet.

      SB

      --
      It's old. The more humans I meet, the more I like my cats. At least they are honest.
    4. Re:Don't try that on the Internet until ... by Biff+Stu · · Score: 1

      The space application doesn't guarantee immunity from a big time lag--just the opposite. If NASA wants to use this for missions to the Moon or Mars, there will be a lag, and it will be quite noticible irregardless of how much they pay for their bandwidth.

    5. Re:Don't try that on the Internet until ... by ScottCooperDotNet · · Score: 1
      Or they could just use Frame Relay.

      *ducks!*

    6. Re:Don't try that on the Internet until ... by shadowbearer · · Score: 2, Interesting

      The system would be totally impractical for earth-bound surgeons to use for Mars trips. Even the moon, with a second and half lag one way, would introduce some bad problems.

        But it seems obvious to me, at least, that this would only be usable with dedicated links, and not over the internet, which is what a lot of others seem to be saying here. I doubt very much that any of the engineers involved have even considered using the public internet (at least I hope they haven't! :-)

      SB

      --
      It's old. The more humans I meet, the more I like my cats. At least they are honest.
    7. Re:Don't try that on the Internet until ... by burndive · · Score: 0, Offtopic
      irregardless

      Please don't use that "word". It's worse than "nukyular." At least nukular has no inherent meaning, whereas "irregardless" implies a double negative meaning: "without lack of regard."

      It's as if abunch of idiots got together and decided they would use the word "unpurple" to mean purple. I want my language to make intuitive sense, please stop making it meaninless.

      The proper word for this context is "regardless". You could also have gotten away with "...irrespective to how much..."

      --
      ...because "hacker" sounds way sexier than "code drone."
    8. Re:Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 1

      Technically, it should be no different than driving the rovers on Mars.

      You take everything as a single indivisible step and don't rush until you know the outcome of the previous one.

      That doesn't work when you're doing surgery. The patient is under stresses that increase the damage to his body and the risk of unsatisfactory outcome (failure of the operation's goal, post-op infection, temporary or permanent impairment, or death) increase with every extra minute the operation takes.

      If you lose packets RCing the orbiter you might delay its operation. If you lose packets in an operation - even if it just slows it - you might maim or kill the patient.

      --
      Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    9. Re:Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 2, Interesting

      Isn't that What T1, OC3, etc. are for?

      Only if they're a TDM point-to-point or switched connection, or a virtual one using something like ATM. In which case it's not the Internet.

      It's connection-oriented, not packet-oriented (even if it's packets being carried,and they're being switched one at a time.) Connection-oriented networks give you a fixed(-maximum)-bandwidth connection with guaranteed delivery and guaranteed limits on latency and jitter.

      Packet switched networks can emulate this, but ONLY with QoS guarantees - guarantees on delivery, latency, and latency variation. That means some packets take precedence over others. They go to the head of the line. When there are too many packets these privileged ones get forwarded while others are dropped. And so on.

      This is NOT something you can build out of best-effort delivery and retransmission, as you build reliable (but variable speed and latency) connections out of unreliable ones using protocols like TCP.

      --
      Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    10. Re:Don't try that on the Internet until ... by syousef · · Score: 1

      Oh yeah no difference at all.

      Mars rover: 40 minutes of lag between steps, and doing something as simple as rotating and rolling wheels based on camera feeback. Coarse grained movements generally okay.

      Surgery: Miniscule accurate movements. If something unexpected happens and the patient starts to bleed getting one thing even slightly wrong kills the patient.

      Only on /.

      --
      These posts express my own personal views, not those of my employer
    11. Re:Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 2, Interesting

      There's no real mention of what exactly they will be using, but I'd bet that "advanced telecommunications technology" doesn't mean internet.

      A QoS-enabled Internet would work just fine. And it's coming - unless misguided "Net Neutrality" laws throw the baby out with the bathwater.

      There are two aspects to "neutrality" and tiered bandwidth.

        - One is using it to distinguish services that need different levels of support - giving them what they need (and perhaps charging extra if appropriate), but treating all services requiring a particular QoS level (including your own) equally.

        - The other is using the tools to implement anticompetive practices, such as penalizing your competitors' packets or charging some customers extra just because they have deep pockets to be picked.

      The first lets a network provider combine guaranteed-QoS and best-effort traffic on a single network and give the best-effort traffic all the remaining bandwidth once the high-QoS stuff is serviced. This is massively cheaper than either of the alternatives: Separate networks, or a permanent bandwidth split on a single one, with the high-QoS partition large enough to handle the maximum load and its unused bandwidth left idle. This saving ends up going mainly to the network users, in the form of lower rates.

      The second is an anti-competitive practice and a worthy target of suppression - by "the invisible hand" if possible, perhaps by law if not.

      --
      Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    12. Re:Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 1

      The space application doesn't guarantee immunity from a big time lag--just the opposite.

      The problem isn't just the lag.

      The problem is lag VARIABILITY and GAPS in data transmission.

      A space application has a fixed time lag and very low packet loss (through forward error correction - to an extreme degree if necessary). In the absense of jitter and the virtual absense of dropped packets, some degree of fixed lag can be taken into account.

      But removing jitter means enough buffering that your resulting fixed lag becomes larger than the worst-case lag. And filling in dropped packets means multiplying the round trip time - and the resulting latency - by a factor of several, or accepting sudden loss of connection at a critical moment. Either can increase the lag to the point that it can no longer be worked around.

      --
      Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    13. Re:Don't try that on the Internet until ... by Ungrounded+Lightning · · Score: 1

      Actually they COULD use ATM. B-)

      --
      Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
    14. Re:Don't try that on the Internet until ... by MillionthMonkey · · Score: 1

      Is Slashdot going to be in the "Silver" package? If I have to order the "Gold" package to get Slashdot then it's been nice talking to you guys but I'm not paying that much!

    15. Re:Don't try that on the Internet until ... by grammar+fascist · · Score: 1

      Please don't use that "word". It's worse than "nukyular." At least nukular has no inherent meaning, whereas "irregardless" implies a double negative meaning: "without lack of regard."

      Actually, it's 100% correct. "Irregardless" is the joculary invective form of "regardless," which is used strictly to show how high-class the speaker is.

      --
      I got my Linux laptop at System76.
    16. Re:Don't try that on the Internet until ... by Tragek · · Score: 1

      And to think, when I read Waldo I though it would be one of those Sci-Fi concepts that would never come true.

    17. Re:Don't try that on the Internet until ... by Anonymous Coward · · Score: 0

      So don't use the Internet for this application. Create a separate network between hospitals. If you were going to implement QOS on the Internet you'd have to replace all the routers anyway, so you're not saving much by using it, but you are losing the equality that makes it so accessible for less vital applications.

    18. Re:Don't try that on the Internet until ... by ceoyoyo · · Score: 1

      Mars doesn't move so much. Patients do. The heart beats, which makes EVERYTHING else pulsate. You know how on TV they open up the skull and the brain is just sitting there? Yeah, it doesn't do that.

      If you'd ever watched a surgeon you'd know how important instant feedback is. Surgeons operate by touch and sound as much as sight. "Okay, I'm feeling that I've cut through the dura and have reached brain... oops, that was a second and a half ago."

    19. Re:Don't try that on the Internet until ... by vacuum_tuber · · Score: 1

      "OK, the cut went well. CLAMP!"

      "Uh, Doctor, blood pressure went to zero between the cut and the clamp."

      --
      Look at the bright side: there's always seppuku.
  7. Awesome. by RoffleTheWaffle · · Score: 4, Insightful

    Now we can outsource the medical field to India, too. *rimshot*

    1. Re:Awesome. by undeaf · · Score: 1

      Actually, AFAIK that is being done already. I heard someone say that they went to, IIRC, taiwan to get some major dental work done because it was cheaper.

    2. Re:Awesome. by iminplaya · · Score: 1

      A lot of Americans go there(and Thailand) now. The prices are as low as one tenth of American prices. And the hospitals are more like five star hotels.

      --
      What?
    3. Re:Awesome. by Tablizer · · Score: 1

      Now we can outsource the medical field to India, too.

      If they outsource my doctor, my automechanic, and my plumber to lower bills, THEN maybe I could start to compete with $4/hr. Indian programmers. Spread The "Love"!

      --
      Table-ized A.I.
    4. Re:Awesome. by startled · · Score: 1

      I had John McCarthy (LISP fame) as a prof for a quarter. He'd talk about all sorts of crazy stuff-- planes that land on perches outside your house, or skilled labor being outsourced to India and such via the use of remotely controlled robots. Well, sure, it didn't help that his example case was haircutting instead of surgery, but he was on the right track. :)

    5. Re:Awesome. by bill_mcgonigle · · Score: 1

      They also have to whack building codes, universal education, social welfare programs, and military spending. Then you might have a chance.

      Let's call it what it is - we get cheap development and tech support, and therefore $29 wireless routers on the backs of villagers in India who are illiterate and don't have a clean supply of water, with a high infant mortality rate. I mean, it's either that or pay $80 for a wireless router, so the choice is clear.

      Americans can't stand not having a slave-like class, be they in Asia or brought in from Mexico. Now that it's illegal to outright own other humans on US soil we simply rent them from foreign countries. It's funny to hear President Bush talk about "jobs Americans won't do" because around here all we have are Americans and, well, the jobs get done. Anything else is purely voluntary and driven by greed. If the middle class feel like they're entitled to manservants they ought to go after the income tax, before which they often had them, mostly in the form of legal immigrants.

      --
      My God, it's Full of Source!
      OUTSIDE_IP=$(dig +short my.ip @outsideip.net)
  8. CounterStrike Surgeons by The+MAZZTer · · Score: 5, Funny

    Probably already been stated, but I can see it now...

    Doctor [Scalpel] Patient
    Doctor: WTF LAG

    1. Re:CounterStrike Surgeons by Anonymous Coward · · Score: 0

      No if it were Counterstrike it would be:

      Doctor[Scalpel]Patient
      Patient: WTF Lag

    2. Re:CounterStrike Surgeons by zaguar · · Score: 1

      No, it would be: Doctor[Scalpel]Patient Patient: WTF Fag

      --
      "Sure there's porn and piracy on the Web but there's probably a downside too."
  9. AMA by UbuntuDupe · · Score: 0, Flamebait

    So how long until the AMA (American Medical Association, doctors' union) makes certain this is never used legally in America (except perhaps at wildly inflated prices), and justifies such a ban on their "noble" concern for patients?

    --
    Apology to Ubuntu forum.
  10. Trouble by tocs · · Score: 4, Funny

    Oh no, I thought the scalpel was moving away from the patient!!!

    1. Re:Trouble by iminplaya · · Score: 1

      I hope they don't use this thing for circumcisions...OR vasectomies!

      --
      What?
    2. Re:Trouble by Anonymous Coward · · Score: 0

      I hope they don't use this thing for circumcisions...OR vasectomies!

      You needn't worry about needing one...this is Slashdot.

  11. At last, the end of greedy american doctors by dogen · · Score: 0

    I can go to a reasonably priced hospital in Mexico and get operated on my the best cheap surgeons in the world in China or Indea. Finally the end of the blood-sucking greedy american medical system.

    1. Re:At last, the end of greedy american doctors by jhylkema · · Score: 1

      No, what will end up happening is, the American hospitals will charge the same for telesurgery (or reduce it by 5%) even though it costs them 80% less and pocket the difference, thus handing the hospitals and insurance companies a windfall. Hey, that's capitalism, and if you're against it, you're a terrorist.

  12. How are they different from these guys... by joecm · · Score: 2, Informative

    http://www.intuitivesurgical.com/

    1. Re:How are they different from these guys... by joecm · · Score: 1

      I suppose I'll answer my own question. I could have sworn I saw this thing on a news program working over a long distance. But according to their website:

      Q. Is this telesurgery? Can you operate over long distances?
      A. The da Vinci Surgical System can theoretically be used to operate over long distances. This capability, however, is not the primary focus of the company and thus is not available with the current da Vinci Surgical System.

    2. Re:How are they different from these guys... by iminplaya · · Score: 2, Informative

      September 7, 2001 - ZEUS robotic system developed by Computer Motion was used in the trans-Atlantic operation. A doctor in New York removed the diseased gallbladder of a 68-year-old patient in Strasbourg, France.

      Apparently these guys are. I believe this is the story you heard...

      --
      What?
    3. Re:How are they different from these guys... by robotngineer · · Score: 1

      The robot used for this mission was developed by SRI International, a non-profit research firm; one of whose spinoffs is Intuitive Surgical. This two-armed robot was developed initially for open trauma surgery for the military, and was upgraded before the NEEMO 9 mission as a deployable system. Here's a link with some information (note that the pictures are rather old; the surgeon side of the system looks different now):
      http://www.sri.com/esd/med_devel/telepresence.html

      You can read more about the mission here and see a very cool picture of the robot suturing with fish in the background:
      http://www.sri.com/news/releases/04-20-06.html

      Not long after suturing was demonstrated at lunar latency; rock samples were picked up with the same manipulators, demonstrating the application flexibility of the robotic arms.
      http://spaceflight.nasa.gov/gallery/images/behindt hescenes/training/html/jsc2006e13997.html

  13. IT people would like to perform the introduction. by dwalsh · · Score: 0, Redundant

    Surgeons, meet offshore outsourcing.
    Offshore outsourcing, meet surgeons.

    --
    ${YEAR+1} is going to be the year of Linux on the desktop!
  14. Re:Roland should at least make clear he's citing t by Anonymous Coward · · Score: 0

    didn't a couple years ago they say that in a couple years remote robotic surgeory would be commonplace?

  15. Wildly Inflated Prices? Don't need to inflate by technoextreme · · Score: 1
    (except perhaps at wildly inflated prices)

    What makes you think that this is going to be cheap?? The only robotic surgery on the market (Da Vinci) is so expensive that people question whether it actually saves people any money even though recovery time is quicker. Not to mention the training involved. Da Vinci was such a radically different way of performing surggery that it took a long time for doctors to get used to the devices. Doctors actually had to abort surgeries because of the complexities. No, I don't think this will be a source of outsourcing anytime soon. It will be useful for rare surgeries though.
    --
    Ooo man the floppy drive is broken. No wait. The computer is just upside down.
    1. Re:Wildly Inflated Prices? Don't need to inflate by fsckr · · Score: 1

      That the technology will definitely get cheaper as time goes by, there is no question. Also, the issues you mentioned that arose with existing robotic surgery are the kind of issues you'd expect with a radically new technology.

      Its only a matter of time before someone in R&D somewhere firgures out how to make the whole process simpler and faster and then before you know it, Dr. Patel from Culcatta will be implanting you wifes boobies at the drive thru plastic surgery joint around the block ;)

      --
      fsckr.com - go fusk yourself!
    2. Re:Wildly Inflated Prices? Don't need to inflate by UbuntuDupe · · Score: 1

      What makes you think that this is going to be cheap??

      What makes you think I thought this was going to be cheap? Given any real number n, there exists a real number m greater than n. I was saying the prices would be inflated relative to what they would be without AMA's noble intervention. Of course it's going to be expensive. AMA will make it so that in America, it's much more expensive than it would be in other countries.

      --
      Apology to Ubuntu forum.
    3. Re:Wildly Inflated Prices? Don't need to inflate by technoextreme · · Score: 1

      Given any real number n, there exists a real number m greater than n. I was saying the prices would be inflated relative to what they would be without AMA's noble intervention. Of course it's going to be expensive. AMA will make it so that in America, it's much more expensive than it would be in other countries.

      Yeah. You missed might point completely. My point was that the price point is going to be so high that it ends up being a zero sum scenario irregardless of outside influences.
      --
      Ooo man the floppy drive is broken. No wait. The computer is just upside down.
  16. THATS THE WHOLE IDEA... by Anonymous Coward · · Score: 0

    Isn't it obvious?

    Doctors and lawyers seem to think that they are somehow immune from being offshored, not so..

  17. It'll be interesting... by grungy+hamster · · Score: 0

    when someone inverts to controls and is responsible as a mass murderer.

  18. Out with Ambulance Chasers by realitybath1 · · Score: 0

    In with Operation Campers.

  19. Re:A new thing you don't want to hear from your do by adamlazz · · Score: 1

    "Oh crap... That wasn't supposed to happen!"

  20. what is the maximum allowed network latency by Rune+Tnnesen · · Score: 3, Insightful

    As a med student and sysadmin I just wondered over a couple of potentially isues

    What the maximum allowed network latency and thereby the maximum allowed operation distance be? Could somebody come with an answer?
    will it do for spacetravel?
    I mean they had to make the marsrovers autonomously, due to transmitting time.

    They say they will take it to the battlefield. Come on it is monstreus piece of equipment, with a weight of approx a ton. For what reason wil they take it to the battlefield.
    Not enough surgeons available at the frontline military service?
    They will still need staff at operation ward, nurses anesthesiologist and so on.

    We have a few of these robots at the university hospitals. Normally we have a group of surgens stading by just in case things goes wrong. We do not trust the machine totally.

    I really do hope they are hackerproff. What and opportunity to blackmail people.
    "Pay me or your husbend will end up without his left kneecap. Your VISA number please"

    Regards Rune

    1. Re:what is the maximum allowed network latency by Anonymous Coward · · Score: 0

      That would depend on the sensitivity of the operation and other factors that seem to indicate a set answer to your question does not exist. If the robotic unit could be installed with some form of AI or fuzzy logic to fill in for the lack of instantaneous human input you could push it further out into space...but some procedures would require near zero latency.

      The mars rover has to deal with the same problems. Ground controller enter information on target to move toward and the rover does the simple en route adjustment to achieve the goal. The question for deep space surgery is when do we get a holographic Dr. like Star Trek Voyager that doens't need any input?

    2. Re:what is the maximum allowed network latency by grammar+fascist · · Score: 1

      What the maximum allowed network latency and thereby the maximum allowed operation distance be? Could somebody come with an answer?

      I wonder if it would depend on the doctor. Network FPS games seem to be a decent analogue to this with regards to latency. Some players adapt just fine, and others never really get it.

      It's not such a big deal now that all of them implement client-side prediction (which a surgical system might be able to do), but back in the days of Quake 1, it was a huge differentiator.

      --
      I got my Linux laptop at System76.
    3. Re:what is the maximum allowed network latency by Anonymous Coward · · Score: 0

      You're a med student? With that grammar and spelling?

    4. Re:what is the maximum allowed network latency by robotngineer · · Score: 1

      There is development currently underway (called TraumaPod) of a robotic telesurgery platform that will be deployable and can get to soldiers almost immediately after being wounded. These systems would provide trauma-mitigation care during transport to a facility where more advanced care can be given.

      For now, telesurgical systems are focused on expanding the surgeon's "reach" to those who don't have access to surgical care (on the very front lines of a battlefield, in space, remote locations, etc).

      For more info: http://www.sri.com/news/releases/03-28-05.html

  21. Personally.. by Kelz · · Score: 2, Funny

    I'm paying my doctor too much already to allow HIM to telecommute.

  22. Advantages and disadvantages... by kcbrown · · Score: 3, Informative
    Advantages: robotics can be extremely precise. If programmed properly, it can compensate for any twitchiness on the part of the operator.

    But the disadvantages are significant: the feel isn't the same as performing the surgery for real. Now, for certain types of surgery that problem isn't a problem, but the human hand is actually quite sensitive to pressures and other types of feedback that I'm sure are quite invaluable to a surgeon (IANAS, however). A machine can provide some of that feedback through the link but the amount of feedback will be limited by the sensory capability of the machine.

    So, like many things, I can see this being useful for a relatively limited set of surgical operations, while for others "being there" will remain necessary.

    That said, if I have to choose between having this and having nothing at all (a battlefield comes to mind for such a situation), I'd rather have this and I'll take my chances with the limitations...

    --
    Use 'slashdot stuff' in the subject line in any email you send me if you want to get past the spam filter.
    1. Re:Advantages and disadvantages... by Swervy_a · · Score: 1

      The problem of "feel" is being solved simultaneously to this remote manipulation technology, though the article may not mention it. Haptic interfaces give mechanical feedback to the controls to convey sensations like texture and viscosity. Using a tool like this I have virtually stirred syrup and cut open a human kidney. The former I can vouch as feeling almost indistinguishable from reality; you might have to find a more educated or psychotic person than myself to vouch for the latter.

  23. Bones vs The Doctor by ScottCooperDotNet · · Score: 1

    What will Bones think when he's replaced by a hologram?!

  24. The AMA? Maybe but there's bigger force... by WidescreenFreak · · Score: 3, Insightful

    You're forgetting the lawyers, though. Can you imagine what malpractice lawyers are going to think? Imagine them trying to sue a doctor who botched a remote surgery in a country with no kind of extradition treaty! I think that the trial lawyers of America would fight this more than the doctors if the goal is to "internationalize" medicine. Allowing remote surgeries will completely screw up many lawyer's ability to go for those higly lucrative malpractice lawsuits if the doctor is outside of the country's borders. But I'll bet that they would fight like crazy to allow it to be used domestically where the doctor and patient are both in the same country because of the ease of filing a lawsuit.

    Personally, with the exception of minor, routine surgery, there is no frickin' way I'd want anyone but a real doctor and real nurses right there with me. Even the slightest possibility of a network dropout while the scalpel is cutting is terrifying to say the least. I don't care how much redundancy there is between me and the remote doctor. There is no way to 100% guarantee a solid connection at any given time, although I'm sure that a number of /.ers would like to try to convince me otherwise. At least with a doctor right there I can hear him say, "Oops!" instead of trusting some doctor who can mute his microphone from a thousand miles away -- and, damn it, they better guarantee <1 ms response time! :)

    Honestly, I think that you asked the right question, but you asked it the wrong way.

    --
    The Overrated mod is for reversing inappropriate, positive mods, not for voicing disagreement with a post.
  25. Heh, And you think by iminplaya · · Score: 1

    alien probes are scary...

    --
    What?
  26. Another joke by Anonymous Coward · · Score: 0

    That's pretty cool. Unfortunately, I have another joke to add.

    *Patient dies*
    Doctor: OMGHax!

  27. Awake during surgery?? by technoextreme · · Score: 2, Interesting
    At least with a doctor right there I can hear him say, "Oops!" instead of trusting some doctor who can mute his microphone from a thousand miles away -- and, damn it, they better guarantee I don't know if I were to wake up and hear the doctor say opps during my surgery I would have to think it would be because I woke up in the middle of my surgery.
    --
    Ooo man the floppy drive is broken. No wait. The computer is just upside down.
    1. Re:Awake during surgery?? by WidescreenFreak · · Score: 1

      Many surgeries can be done with local anesthetics. I never said that my desire to have a doctor right there was restriced to major surgeries!

      --
      The Overrated mod is for reversing inappropriate, positive mods, not for voicing disagreement with a post.
  28. Re:A new thing you don't want to hear from your do by 0racle · · Score: 2, Funny

    Dr. Leroy Jenkins MD

    --
    "I use a Mac because I'm just better than you are."
  29. What is it with Canadians by Winlin · · Score: 2, Funny

    and robotic arms? Are there secret Mech bases out there in the tundra or something? Well I for one welcome our remotely controlling, Molson dispensing overlords, eh.

    1. Re:What is it with Canadians by ceoyoyo · · Score: 1

      No. We have no Mech bases. Look, there's an episode of American Idol!

    2. Re:What is it with Canadians by Winlin · · Score: 1

      Well, I'm still a bit suspi....oooh.....shiny!

  30. I, for one... by Silicon+Jedi · · Score: 0, Redundant

    I, for one, welcome our robotic surgeon overlords.

  31. a fat pipe doesn't change the law of physics by Anonymous Coward · · Score: 0

    Firstly the comment says hundreds or thousands of kilometers away (it's "or", not "of", like some of the people in this thread seemed to think). Real-time surgery of a Mars settler by a chirurgian on earth won't happen anytime soon unless a major science breakthrough happens.

    Secondly no matter how 1311t your fat pipe is, you will not be pwnzoring the law of physics. Show me a ping between the old continent (say Paris, France) and L.A....

    It won't be lower than 100 ms. It doesn't matter if the diameter of your fiber-optic cable is 10 cm or 10 meters, light won't travel faster.

    Even if the bandwith is sufficient to display HD-DVD quality movie on a 60" Plasma at the doctor's end (damn rich doctors ;) , there will be latency. There will be delay between the image he sees and what's really happening.

    Now a delay of 20 ms may not be noticeable, but once it's 200 ms I'm not so sure.

    I hope that if one day I need this and there's only one chirurgian able to save me he won't be located on the other side of the globe ;)

  32. da vinci system by VoidEngineer · · Score: 2, Informative

    For more information on telerobotic surgery systems (they're a few years old now):

    http://www.teleroboticsurgeons.com/
    http://www.teleroboticsurgeons.com/davinci.htm
    http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd= Retrieve&db=pubmed&dopt=Abstract&list_uids=1471286 6

  33. Cyberdyne Corporation beat them to the Punch by Anonymous Coward · · Score: 0

    I saw Cyberdyne actually showing a promo video at an open house at a local theme park. They had a doctor on the beach performing a brain surgery operation. They also had robot arms, tuck a young girl in to bed too.

    I thought it was going well, then it was attacked by some "freedom fighters".

    One of them looked really butch(the girl), and the kid looks like a addict/punk to me...

  34. Re:Piquepaille is still a shit-eating spammer. by Anonymous Coward · · Score: 0

    so whats your problem then? he does what everyone wants him to do, you can hardly complain about him now

  35. You say "remote"? by kbahey · · Score: 1

    Voice: forceps please ...

    Background: blip blip blip

    Voice: Good ...

    Background: blip blip blip

    4#@@#*()(*&&^^
    NO CARRIER

    Background: bleeeeeeeeeeeeeeeeeeeeeeeeeep

    --
    2bits.com, Inc: Drupal, WordPress, and LAMP performance tuning.
  36. Re:Ironically by Noxal · · Score: 1

    Agreed.

  37. From the Western Redundancy Playhouse Theater... by shoolz · · Score: 2, Funny

    Wouldn't simply Robotic Telesurgery be an appropriate title? Wouldn't simply Robotic Telesurgery be an appropriate title?

  38. Creepy by Noxal · · Score: 1

    I'm sure this has the potential to save lives, but the thought of being operated on by an actual doctor freaks me out, so the thought of someone doing that with a machine over a network just...ugh. Very discomforting.

    1. Re:Creepy by CptNerd · · Score: 1

      AMEN! I've been able to avoid major surgery my whole life, and I can just picture all the things that can go wrong during a live operation, much less during a "teleoperation." And think of the liability issues. You think it's hard getting service for your computer ("It's the software!" "No, it's the hardware!" etc. etc) just imagine having to sue the hospitals at both ends, the doctor(s), the hardware manufacturers, the network admins, the ISPs, etc., none of whom admit to any error on their part.

      Unless it's the only way to save my life, then I'll think about it. Until then, I'm on the parent poster's side...

      --
      By the taping of my glasses, something geeky this way passes
    2. Re:Creepy by terciops · · Score: 1

      Too right - and with the ping times we get in New Zealand you would bleed to death before the surgeon at the other end even knew he had knicked an artery.

    3. Re:Creepy by Noxal · · Score: 1

      I can just see a surgeon sitting at a console, screaming, over and over again... "FUCKING LAG!"

    4. Re:Creepy by Noxal · · Score: 1

      Local staff (anesthesiologist, nurses, etc), equipment that's not the main cutbot, the cutbot, the cutbot's software, the connection, the medium that holds the connection...and all that on the other side. Those are too many variables for something as serious and delicate (or brutal) as surgery can be.

    5. Re:Creepy by electr01nik · · Score: 1
      Yoky Matsuoka, a roboticist from Carnegie Mellon University agrees with you (the network part at least), as stated in May 2006 'Ping' in Wired Magazine: 'I am not ready to undergo a serious remote procedure. The best surgeons are known for their superb dexterity and their ability to handle unusual complications. These abilities are significantly affected by network delay and the lack of realistic tactile feedback that soft tissue provides. As a robotics expert, I've seen too many half-working prototypes to be anything but cautious.'

      However, James 'Butch' Rosser, Chief of minimally invasive surgery, Advanced Medical Technology Institute, Beth Israel Medical Center says: "If I'm in the middle of New York or Houston, it makes no sense to have a guy across town operate on me with a robot. If my life is on the line with acute appendicitis in an isolated place, like the Serengeti or a space station, I would elt an expert in the field operate from afar. Especially if he's good at Halo 2 (emphasis mine).

  39. Re:IT people would like to perform the introductio by LordEd · · Score: 1

    For heart surgery, press 1
    For brain surgery, press 2
    *BEEP*
    I'm sorry, that isn't a valid entry. Please wait on the line for the next available operator.

  40. Hmm by $exyNerdie · · Score: 1

    I wouldn't want to get that done on me if I worked for Blue Security. Imagine a Russian spammer getting tip off from a buddy. A DDoS and surgeons will see "Buffering..please wait.."

  41. YES! Some critical surgeries are performed awake. by Were-Rabbit · · Score: 1

    Being awake during certain surgeries is not common, but by no means is it unheard of.

    http://www.mayoclinic.org/awake-brain-surgery/cand idates.html
    http://www.mayoclinic.org/awake-brain-surgery/brai n-mapping.html
    http://www.expresshealthcaremgmt.com/20041015/hosp inews03.shtml
    http://www.nmff.org/clinicaldepts/deptnewsstory.as p?id=137&page=3
    http://www.blonnet.com/2005/06/24/stories/20050624 01531700.htm

    In the words of Foamy, "Do a damned Google search!"

  42. At last, medicine can be totally offshored by Animats · · Score: 1

    The doctor will be in a call center in some low-wage country, of course.

  43. Done to Death, but... by Bieeanda · · Score: 1

    "Physician, route thyself."

  44. Advantage: Simulation by arrrrg · · Score: 1

    One huge advantage of such a system is that one could write a human surgery simulator much easier than one could construct a robust, responsive physical simultation of a human under surgery. Doctors can have done 100 surgeries almost exactly like the real thing (and have watched "virtuoso" recordings of past surgeries) before ever putting a patient's life on the line.

  45. But the question remains... by Anonymous Coward · · Score: 0

    Does it run Linux?

    *ducks*

  46. Heh, how long .... by Anonymous Coward · · Score: 0

    until the doctor on the other end is replaced by an expert system for some, if not all operations of a given type?

  47. 2 Words. by Anonymous Coward · · Score: 0

    Packet loss.

  48. h@ck3d by Tablizer · · Score: 3, Funny

    All your spleen are belong to us

    --
    Table-ized A.I.
  49. On the plus side... by MadTinfoilHatter · · Score: 1
    ...DDOSing spammers may finally be charged with murder, and sentenced to death.

    On second thought I'm not sure that first part is really a good thing.

  50. Offshoring potential by EmbeddedJanitor · · Score: 1
    This has really got nothing to do with NASA and space stations. Consider the potential for offshoring surgery. Indian/Chinese/whatever surgeons operating telepresence remote bots. All the hospitals will need are a few low-skill orderlies to strap the victims to the tables and give the bot a squirt of oil now and then. Should make for cheaper surgery and better profits for the health insurance companies.

    Sounds like whoring for a funny rating, but not so. There are millions to be saved in surgery bills $20/hr Indian surgeon vs $500/hr US surgeon ... and they don't go play golf every Wednesday afternoon.

    --
    Engineering is the art of compromise.
    1. Re:Offshoring potential by Zaphod2016 · · Score: 1

      If *I* was the one going into surgery, this is a hard sell to begin with. If I was told the doctor was physically located on the other half of the world, I would most likely run from the room crying.

      Most Indian and Chinese doctors I have met personally practice medicine in New York, and are just as competent as anyone else. I don't care WHO was on the other end, the very idea makes me nervous.

      Just thinking about this I picture the "select a mirror" page on surgeforce, and start scanning for the (missing) "standing next to me" option.

      --
      barack to the future?
  51. Germs travel over the Internet! by SpleenVenter · · Score: 1

    I can't think of any other reason the surgeon in the linked photo (who is described as being far away from his patients) in the additional details and pictures link is wearing scrubs and a hairnet.

    1. Re:Germs travel over the Internet! by Anonymous Coward · · Score: 0

      I guess he must not have renewed his outrageously priced subscription this year, so he's concerned that his anti-virus protection isn't going to be able to protect him against the latest viruses!

    2. Re:Germs travel over the Internet! by ceoyoyo · · Score: 1

      Would you trust a guy sitting at a computer in shorts, t-shirt and sandals to do surgery? How about one who hadn't showered recently?

  52. What will they use? by LordVader717 · · Score: 1

    Will they be using this as the interface software?

  53. waldos can be good by hogghogg · · Score: 2, Insightful

    I didn't RTFA, but a thorassic surgeon I know told me that using a waldo in lung surgery can be very useful, because the machinery can scale down your motions, making it possible to perform extremely precise, tiny cuts and stitches, etc; for some operations a waldo is indispensible, apparently. I have to admit that this doesn't have much to say about the idea of remote operation, but I, for one, will welcome our scalpel-wielding aluminum overlords when I need some surgery.

    --
    David W. Hogg -- assoc prof, NYU Physics
    1. Re:waldos can be good by Anonymous Coward · · Score: 0

      A robotic surgical system also provides added dexterity for a minimally-invasive procedure over conventional laparoscopic techniques; meaning that more complex things can be done.
      The daVinci (Intuitive Surgical) has gotten a lot of publicity for being used for prostatectomies -- obviously, there's not a lot of room down there to do things, so I'm all for giving the surgeon added dexterity down there. :)

  54. Okay, what I want to know is by jhylkema · · Score: 1

    What are we going to do when we've outsourced *everything*?

    Okay, kids aren't getting CS degrees because there are no jobs to be had, they've all been shipped to India (or China, or whatever other shithole^H^H^H^H^H^H^H^H"low-wage country".) Eventually, we'll stop training our own programmers. Now, India doesn't like the fact that we're not going to let them nuke Pakistan back into the stone age, so what do they do? They cut us off. Now what? We saw something similar in the '70s with OPEC. Similarly, we don't grow our own food (we're building McMansions on some of the richest farmland in the world). Face it, we're being sold down the river for the sake of next quarter's numbers.

    I'm to the point where I'm ready to get while the getting's good.

    1. Re:Okay, what I want to know is by jasonhamilton · · Score: 1

      It's even worse than that.

      why did the south lose the war, class?

      It's because they did not have the centers of manufacturing that the north possessed

      when you are faced with a national emergency, whether natural disaster, disease, war, or any other calamity, you have to retool your factories to meet the demand of that emergency. If you do not have the factories to begin with, you lose.

      --
      SearchIRC - Now with live chat directory!
  55. Don't try that on the Internet ever... by Vellmont · · Score: 1

    QoS hooks aren't going to do much good if someone along your normal network path decides to upgrade a router, taking down your connection at least momentarily.

    I highly doubt that surgery would ever take place over the internet. It's just too unreliable to put someones life dependent on it. This kind of thing is far more likely to be used on dedicated point to point links.

    --
    AccountKiller
  56. Long-distance heart operation this week by worf_mo · · Score: 2, Interesting

    This week, a long-distance heart operation has been carried out. The operation was initiated and monitored in Boston, the surgery took place in Milan, Italy.

    1. Re:Long-distance heart operation this week by Anonymous Coward · · Score: 0

      The first transatlantic operation dates back from september 2001, with a dedicated high-speed link from France Telecom. See http://www.hoise.com/vmw/01/articles/vmw/LV-VM-10- 01-20.html. It was not a heart operation (the bladder ?), and it was not robotic (there were real surgeons at the other end). But I am not sure it will be widely used, because you need to have very strong guarantees about the time lag, that you can not have on the Internet.

  57. Redundant by Zygamorph · · Score: 1

    "Robotic Telesurgery done by remote surgeons" seems a bit redundant. If the surgeons weren't remote it wouldn't be "tele". I.E. Telecommunications is communications between people who are remote from each other.

  58. Two words for interplanetary surgery.... by maddogdelta · · Score: 1

    Time lag...

    --
    -- There are 10 kinds of people in the world, those who understand binary and those who don't.
  59. And what if you get lag out there man? by Rooked_One · · Score: 1

    I heard there were no respawn points......

  60. Re:The AMA? Maybe but there's bigger force... by ceoyoyo · · Score: 1

    Meh, sue the hospital. They have more money anyway.

  61. Re:A new thing you don't want to hear from your do by srmalloy · · Score: 2, Funny

    This is going to bring a whole new meaning to "blue screen of death".

  62. MS by advs89 · · Score: 0

    {scapel}
    -->move 10.087,10.422,3.003
    -->move 14.027,6.4,-3.123

    "An exception has occurred at 0x00010234, Windows will now restart. Press any key to continue"

    Restarting...

    Windows XP :: Build 1.00010204231
    -->
    -->echo heart_rate
    ?
    -->

    --
    Rirelobql xabjf gung EBG-13 vf gur yrnfg frpher rapelcgvba rire, ohg jbhyq lbh jnfgr lbhe gvzr npghnyyl qrpelcgvat vg???
  63. Re:Roland should at least make clear he's citing t by vacuum_tuber · · Score: 1
    didn't a couple years ago they say that in a couple years remote robotic surgeory would be commonplace?

    Yeah, like those flat-proof tires that could even sustain a bullet puncture, that were showcased in Popular Science about 40 years ago. They were going to be available soon and were supposed to revolutionize the field of automobile tires. We never heard a peep about them after that.

    --
    Look at the bright side: there's always seppuku.
  64. It really doesn't sound practical by drriley · · Score: 1

    I don't think that robotic telesurgery will every be practical or utilized outside of extreme situations such as those encountered with deep space travel. There are just too many variables and too much else involved in patient care to make this something that will ever be utilized, for example, in the Canadian North (I thought it was laughable that this was a venue that was suggested as one where robotic telesurgery could be widely utilized to help cut down on dollars spent transporting patients South for treatment): I'll link two examples from the article -- the mention of Canada's North and a separate mention of emergency open cardiac surgery in the back of an ambulance -- and address a few of the critical reasons why robotic telesurgery would not be practical for complex cases. People would very wrongly believe that telerobitics could allow for patients in Canada's far North (or anyone anywhere, for that matter) to have access, in their home community to cardiovascular surgical services. Such patients require extremely specialized pre- para- and post-surgical care. Even if the patient could be successfully diagnosed via telemedicine, who is going to provide surgical support, anaesthesia, perfusion, pharmacy, critical care med/nursing, RT/ventilation, etc. There are so many issues -- that is one to thing about. One other, briefly, is the matter of who are the surgeons that will perform these procedures? We have so few surgeons (there is a global shortage) to begin with, and they all have very full and busy practices managing their "live" patients -- who are these surgeons that are going to have time to manage telemedicine/telerobotic patients for something so complex as surgery? Managing a simple check-up via telemedicine is cumbersome enough.