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Florida Hospital Shows Normal Internet Lag Time Won't Affect Remote Robotic Surgeries
Lucas123 writes: Remote robotic surgery performed hundreds or even thousands of miles away from the physician at the controls is possible and safe, according to the Florida Hospital that recently tested Internet lag times for the technology. Roger Smith, CTO at the Florida Hospital Nicholson Center in Celebration, Fla., said the hospital tested the lag time to a partner facility in Ft. Worth, Texas and found it ranged from 30 to 150 milliseconds, which surgeons could not detect as they moved remote robotic laparoscopic instruments. The tests, performed using a surgical simulator called a Mimic, will now be performed as if operating remotely in Denver and then Loma Linda, Calif. The Mimic Simulator system enables virtual procedures performed by a da Vinci robotic surgical system, the most common equipment in use today; it's used for hundreds of thousands of surgeries every year around the world. With a da Vinci system, surgeons today can perform operations yards away from a patient, even in separate but adjoining rooms to the OR. By stretching that distance to tens, hundreds or thousands of miles, the technology could enable patients to receive operations from top surgeons that would otherwise not be possible, including wounded soldiers near a battlefield. The Mimic Simulator was able to first artificially dial up lag times, starting with 200 milliseconds all the way up to 600 milliseconds.
Sounds good until you hit a latency spike. I'd hate to be getting sutured up and see the ping times climb to 2000 ms.
See my journal for slashdot ID's by year. Mine created in 2005. http://slashdot.org/journal/289875/slashdot-ids-by-year
I'm getting this image of a heart surgeon listening to canned music on Comcast's help line. "Your call is very important to us. Please stay on the line for another three days and...".
Agreed. I can't play Wii when not using "game mode" to reduce delay on my TV, or record & monitor multitrack audio above a 6-8 ms delay. No way would I trust a surgery to anything more than 10ms in case something unexpected happened during surgery.
Florida Hospital Shows Normal Internet Lag Time Won't Affect Remote Robotic Surgeries
So what? It's not normal lag you are worried about. It's severe lag which on the normal internet you cannot guarantee you can eliminate. It's interesting information but I'm not sure if it's really useful information.
You won't have to worry about it for long. Da Vinci is almost certainly logging these surgeries for the purpose of training autonomous surgery robots.
Just like autonomous cars: in the beginning you'll only see "simple" operations automated(with supervision) but as time goes on: you'll have perfect repeatability from patient to patient.
There are plenty of third world countries where desperate people will sign up for a hair cut at a steep discount from an academy. By "hair cut" I mean "surgery" of course, and once the robots have better batting averages than the human surgeons: you'll see them integrated in first world countries like "self checkout" machines at the grocery store. E.G. 5 or so surgeries being supervised by a singly human surgeon who is present "for emergencies".
When the robots go long enough without any major intervention: the ratio of concurrent surgeries to doctors present will continue to increase until the "human surgeon" is as real as elevator inspection records. Hypothetically available, but not necessarily real as nobody from the general public ever sees them.
I'm guessing it isn't noticeable because of how slowly and deliberately they move to begin with. Surgery isn't exactly a twitch reflexes exercise.
Next is holograms lawyers in courtrooms!!!
Please state the nature of the legal proceeding...
Lose = not win
I have to admit, this one had me scratching my head.
Don't medical safety guidelines always require safe handling of the *worst* case scenario, not the *average* case scenario? Hospitals have network outages, and have plans in place to mitigate that. How do you mitigate a surgeon losing link while he's cutting the right ventricle? When you're yards away and the link goes down, you just scrub in. When you're on the other side of the world....
Wow. "How'd he die?" "Lag." Been true plenty of times in World of Warcraft, and now possible IRL.
We don't have a state-run media we have a media-run state.
Denial of Surgery attacks? Handled by the lawyers, I'd expect.
Defending IP by destroying access to it? That makes sense, RIAA/MPAA. Go to the corner until you can play nice!
I read the article, thinking this was an incorrect claim in the summary. Nope, the article insists in several places that it was "undetectable" by the surgeons. Now, anyone who's played any online FPS knows that 50ms ping times are not only detectable, but are approaching unplayable because some punk kid that's only 10ms away from the server is always taking the head shots before you can even see him.
So I figured there has to be something else. The best hypothesis I could come up with is the current robotic surgery tools introduce their own lag such that the surgeons were unable to distinguish normal device response times from network latency. That, and the goals of a surgeon are completely different from an FPS shooter. A surgeon isn't trying to race anything or anyone - they don't have to shoot first. In a live operating theatre, they are methodical and cautious. It's not like there are sudden surprises that leap out at them that they have to instantly react to. Even a burst blood vessel takes a few moments to assess and plan a recovery from. So maybe if they're used to very slow approach, the latency doesn't impact them as much.
John
For your upcoming remote surgery, please note that fast Internet response times ensure an effective procedure with the best post-operative outcomes. Your insurance carrier, however, covers only basic Internet service. If you wish, you may elect to have faster guaranteed response times for an additional fee. Please select from one of the following four options:
1. 500ms response time $500.00
2. 250ms response time $750.00
3 100ms response time $2000.00
4. 50ms response time $5000.00
Sincerely, AT&T
We Appreciate Your Patronage
Next is holograms lawyers in courtrooms!!!
Don't fret. Congress is staffed almost entirely by lawyers, and there is zero chance they'll let their bread-and-butter be outsourced or replaced by machines. They already won't even pass laws to simplify laws, in order to keep their jobs as clever interpreters of the cracks between the laws.
They'll damn everyone else to a subcontracted devil running an outsourced version of hell, but they've proven they're going to protect their jobs forever.
John
You solve this by running the remote surgery in a hospital that still has local doctors and nurses. One general doctor can be in house and prepped for surgery, on call for one or more operating theatres. The patients will still need local nurses to prep the patients, physically administer the anesthesia (in the case of a remote anesthetist), and handle all kinds of tasks. The remote surgeon makes the cuts, does the work, then closes up behind himself as he leaves. The whole time the local nurse(s) is(are) monitoring vitals, and watching for problems. If anything comes up that can't be remotely managed, the nurse signals for the on-call doctor to come in and handle the situation. All the local doctor really needs are the skills required to close up and remove the machine from the patient - they don't have to complete the delicate surgery if it's beyond their capabilities.
John
When I talked to one of our VAR's he said that one of the local hospital chains was one of his best and worst customers, best because of all the expensive gear they bought, worst because they were so demanding. They actually paid to have trenching done to make sure that their backup link at one facility went out a different CO which was on a different uplink facility (ie truly divergent paths with no single mode of failure), and that was just for PACS, not telesurgery.
There are 4 boxes to use in the defense of liberty: soap, ballot, jury, ammo. Use in that order. Starting now.
I read the article, thinking this was an incorrect claim in the summary. Nope, the article insists in several places that it was "undetectable" by the surgeons. Now, anyone who's played any online FPS knows that 50ms ping times are not only detectable, but are approaching unplayable because some punk kid that's only 10ms away from the server is always taking the head shots before you can even see him.
Uh...if you are worried about the patient moving faster than you, perhaps it would help if you sedated the patient before starting the operation?
The brain adapts very well to lag. If you rig up a button and a light, so the light lights up when you push the button, then gradually introduce a delay, the brain will - up to a certain point - adapt and you'll still think the button push and light are happening at the same time. Remove the delay without warning, and you'll be convinced that the light lit up before you pushed the button.
Surgery isn't like a first-person shooter, cries of "but the lag!" notwithstanding. Surgeons aren't, for the most part, waiting for the right bit of aorta to bob into their crosshairs so they can jab it with a scalpel, nor are they competing against other surgeons to get the first stitch in.
Of course spikes in lag - and connections dropping entirely - are a big concern. But I don't think anyone's suggesting hospitals all move to remote working just because they can just yet.
systemd is Roko's Basilisk.
I hope you never need surgery then, since the typical delay between observing something and *starting* to react to it is an order of magnitude *larger* than your stated maximum. And that's for a *local* observer who is already hands on. [1]
Of course, since *typical* internet lag (on a connection *not* routed through a satellite) is in the neighborhood of 30-150ms (round trip), you're still not in any actual danger since lags an order of magnitude higher than that didn't effect the surgical process.
Seriously, if you think 1/100th of a second (10 ms) actually means anything in surgery, you're either severely mistaken, or no patient has ever survived a surgical procedure where anything unexpected has happened. Since we know the latter isn't true, we can state with confidence that you are mistaken.
[1] The average reaction time for humans is 0.25 seconds to a visual stimulus, 0.17 for an audio stimulus, and 0.15 seconds for a touch stimulus. (That's 250ms, 170ms, and 150ms respectively.)
I would expect much like digital telephony lag is not much of challenge to overcome unless its really really big.
Jitter would be a problem. The human brain is pretty good at adapting to consistent latency, anticipating events, delaying or cramming inputs as required to compensate. Where that breaks down is when the latenecy is sometimes 200ms and other-times 500ms without predictability. Controlling jitter on the public parts of the Internet is hard.
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