timothy j. broderick, md, facs associate professor of surgery/bme university of cincinnati

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

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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. Telemedicine and Telesurgery. Telecommunication: sending message by means of electronic transmission of impulses - PowerPoint PPT Presentation

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Page 1: 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

Page 2: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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”

Page 3: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 4: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 5: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

Computer Motion Zeus SRI M7

Intuitive daVinci* University of Washington

Telesurgery Systems

Page 6: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 7: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 8: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 9: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 10: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

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

Page 11: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

DARPA Trauma PodAutonomous, telesurgical combat casualty care

Critically Injured warfighterMultiple video streams and robot controls

Wireless UAV based communication and transportBandwidth and more bandwidth…

Page 12: Timothy J. Broderick, MD, FACS  Associate Professor of Surgery/BME University of Cincinnati

Mobile Robotic Telesurgery Conclusion

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