Timothy J. Broderick, MD, FACS

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Mobile Robotic Telesurgery

• Timothy J. Broderick, MD, FACS
• Associate Professor of Surgery/BME
• University of Cincinnati
• NASA NEEMO
• US Army TATRC
• DARPA Trauma Pod

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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

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Telecommunications in Surgery
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Telemedicine
Attn MichelNow 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.
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Telesurgery Systems
Computer Motion Zeus
SRI M7
Intuitive daVinci
University of Washington
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Robotic Telesurgery
Operation Lindbergh 8Mbps 155msec ATM network
Zeus TS New York - Strasbourg Laparoscopic
cholecystectomy Sept 7, 2001
CMAS 45 Mbps 144msec IP MPLS VPN Zeus
TS Hamilton - North Bay Laparoscopic Nissen
Fundoplications February 28, 2003
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Robotic Telesurgery Using daVinci
April 2005
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NEEMO 9 Robotic Telesurgery
Telesurgery firsts Extreme environment (SRI
M7) Microwave wireless (less than 10
Mbps) Lunar latency (2 sec -gt 10 minute
suture) Latency compensation (gt 500
msec) Techniques (slow, one handed) Technology
(bandwidth, CODEC, automation)
April 2006
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Mobile Robotic Telesurgery
UW robot
AV PUMA SUAV DDL _at_ 1.2 Mbps (15 ms) Latency _at_ 200
ms (CODEC)
Internet
Remote Patient (high desert)
Expert Surgeon (desert and UW)
June 2006
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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
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DARPA Trauma PodAutonomous, telesurgical combat
casualty care
Critically Injured warfighter Multiple video
streams and robot controls Wireless UAV based
communication and transport Bandwidth and more
bandwidth
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Mobile Robotic Telesurgery Conclusion

• High bandwidth, low latency wireless
  telecommunication can improve the quality of and
  access to surgical care

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timothy.broderick_at_uc.edu