Thursday, June 25, 2015

Are they crazy?

Computerworld reports on a test to see if robotic surgery can be conducted remotely--1200 miles away--checking to see if the lag time between the operators actions and the surgical incisions and other tasks would be too long.  Excerpt:

A Florida hospital has successfully tested lag time created by the Internet for a simulated robotic surgery in Ft. Worth, Texas, more than 1,200 miles away from the surgeon who was at the virtual controls. 

Next, the hospital plans to test lag times for remote robotic or "telesurgery" in Denver and then Loma Linda, Calif. 

"Based on these tests, we have determined that telesurgery is possible and generally safe for large areas within the United States," said Roger Smith, CTO at the Florida Hospital Nicholson Center in Celebration, Fla., where the tests were performed. "Limitations are no longer due to lag time but factors associated with reliability, social acceptance, insurance and legal liability. 

Let's put aside "reliability, social acceptance, insurance and legal liability."

Let's just think about what happens when, in the middle of laparoscopic surgery, a complication occurs and the surgery has to switch to "open" mode--and quickly.

Is this what the CTO means by "generally safe?"

8 comments:

Anonymous said...

C'mon now. The research is useful for emergencies in remote locations. Didn't some medic in Antarctica have to remove his/her own appendix? This technique would've been right handy.

I understand your loathing for the DaVinci people but don't let that color ALL robitic options.

Paul Levy said...

You are so right. I apologize. So, as you prepare to leave for Antarctica, spend an extra $2 million on equipment and supplies and carry that robot with you . . .

Anonymous said...

I have heard about this research in the setting of space travel....but, lag time IS the big issue in that setting.

nonlocal MD said...

I do think it would be useful for, say, complex non-elective surgeries in poor countries. In those settings the conversion to open surgery would either be a moot point or would be accomplished by an on-site surgeon standing by. If Intuitive wanted to do some useful marketing for a change, they could provide the instruments with which to do so free of charge.
And, do remember that we now allow stenting in hospitals without open cardiac surgery backup, which used to be verboten.

Pat said...

Or when a thunderstorm hits Florida and internet goes down for hours!

Tom said...

Robots are so cool. Let’s see if we can do surgery on someone in a space capsule. If it goes bad we can just eject the body. Are we caring for patients or playing video games?

Carole said...

Can you imagine the risk list on that consent form? And Pat brought up the biggest risk of all,Mother Nature...

Paul Levy said...

I'm also curious to think through how the surgeon, far away, would be sure that the robotic instruments are correctly aligned in the OR.

Think through the time out procedure, too.

And how the anesthesiologist would communicate in real time with the surgeon.

But I guess all of this falls under the term "generally safe."