Timothy J. Broderick, MD, FACS Associate Professor of Surgery/BME University of Cincinnati
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Transcript of Timothy J. Broderick, MD, FACS Associate Professor of Surgery/BME University of Cincinnati
Timothy J. Broderick, MD, FACS Associate Professor of Surgery/BME
University of Cincinnati NASA NEEMO
US Army TATRCDARPA Trauma Pod
Mobile Robotic Telesurgery
Telemedicine and Telesurgery• Telecommunication: sending message by means of electronic transmission of impulses
• Telemedicine: application of telecommunications in medical care
• Surgical Robot: a powered, computer-controlled manipulator with artificial sensing that can be programmed to move and position tools to carry out a wide range of surgical tasks (telemanipulator)
• Telesurgery: remotely performed surgery through combined use of telecommunications and a surgical “robot”
Telecommunications in Surgery
Telemedicine Telesurgery Security Encrypted Encrypted VPN Protocol IP IP Bandwidth Kbps Mbps (video) Latency Asynchronous Lowest QoS Low Highest Availibility Widespread Limited Cost Low Prohibitive
Attn Michel
Now for the alligator pt.He is a 51 year old Police Reserve who resides at Tana River District approx 200 kms from Mombasa. The District derives its name from Tana River which is the longest river in Kenya and supplies most of the hydroelectric power in the country, It is inhabited by a large number of alligators which annually maims/kills a large number of poeple and domestic animals. Mamba Village gets some of the alligators from there.
The subject sustained his injuries 10 days ago when he went to fetch water from the river in the evening( Because of fear of alligator attcks it is males who dare go to the river on the evenings. An alligator jumped from underwater and bit his right hand as he was drawing water causing the injuries described earlier. He is in got nutritional status is right handed and is also a farmer so he uses both his hands while performing his daily tasks including shooting a rifle. He has no motor or sensory deficit and is able to flex and extend his fingers.He is having daily dressing with betadine and as of today the wound is clean and is on splint.
Telemedicine
Computer Motion Zeus SRI M7
Intuitive daVinci* University of Washington
Telesurgery Systems
Robotic Telesurgery
Operation Lindbergh8Mbps 155msec ATM network + Zeus TS
New York - StrasbourgLaparoscopic cholecystectomy
Sept 7, 2001
CMAS45 Mbps 144msec IP MPLS VPN + Zeus TS
Hamilton - North BayLaparoscopic Nissen Fundoplications
February 28, 2003
Robotic Telesurgery Using daVinci
Network
Distance Delay 3D Vision
Robotic Motion
Telesurgery Firsts
Cincinnati to
Sunnyvale
Public Internet(3Mbps)
2500 miles
900 ms PoorPolycom
Smooth USdaVinci
3D
Denver to
Sunnyvale
Public Internet(3Mbps)
1300 miles
450 ms GoodHaivision
Smooth Collaborative (2 -> 1)
April 2005
NEEMO 9 Robotic TelesurgeryTelesurgery firsts:
Extreme environment (SRI M7)
Microwave wireless (less than 10 Mbps)
Lunar latency (2+ sec -> 10 minute suture)
Latency compensation (> 500 msec):
Techniques (slow, one handed)
Technology (bandwidth, CODEC, automation)
April 2006
Mobile Robotic Telesurgery
Internet
Remote Patient(high desert)
Expert Surgeon (desert and UW)
UW robot
AV PUMA SUAVDDL @ 1.2 Mbps (15 ms)
Latency @ 200 ms (CODEC)
June 2006
Robotic Surgery in Microgravity
• Targeted open procedures
NASA: Spaceflight
DoD: CCAT
• Robotic surgery in parabolic flight
Upgraded SRI M7
Telerobotic (802.11g in aircraft)
Inanimate (suturing)
Semi-autonomous function
August 2007
DARPA Trauma PodAutonomous, telesurgical combat casualty care
Critically Injured warfighterMultiple video streams and robot controls
Wireless UAV based communication and transportBandwidth and more bandwidth…
Mobile Robotic Telesurgery Conclusion
• High bandwidth, low latency wireless telecommunication can improve the quality of and access to surgical care