Da Vinci robot: Future of surgery

[okarol]

Da Vinci robot: Future of surgery
By: Sam Ohmer
Posted: 10/29/09

The future of surgery is . . . Wall-E? Well, sort of.

The Da Vinci surgical robot currently making its home in the Mock Operating Room in the Computer Science and Engineering Building here at Homewood is pretty loveable, as far as robots go. But the Da Vinci robot is also much more than just a pretty motherboard or some fancy software.

The Da Vinci machine consists of a surgical section - which features not only mounts for various "wristed" implements a surgeon might use during a procedure, but also a high-definition "3D" camera that transmits the image (usually from inside a patient) to a console at which the surgeon sits. It is also at this console where the surgeon directs the robot's movements via two small sets of loops that fit around the fingers of the operator.

It was developed by the medical technology company Intuitive, and is now currently on loan at Hopkins. About a thousand other robots like the Da Vinci are currently in use around the world. With the Da Vinci and its cousin machines, scientists and surgeons hope to take advantage of the many benefits of surgical assistant bots: anatomical modeling, surgical planning, medical imaging and a greater range of motion for surgical instruments.

Currently, robots similar to Da Vinci are used for laparoscopic surgeries that involve making two small incisions in the patient, one into which a camera is inserted and the other into which the actual surgical instruments are placed. Currently, similar surgical robots are used in a variety of laparoscopic surgeries, including nephrectomies to remove cancerous kidney tumors, heart valve repair and some gynecological procedures.

However, much of the research at the Engineering Research Center for Computer Integrated Surgical Systems and Technology (ERC CISST), which is based at Hopkins, is also aimed at microscopic surgeries, which will overcome the physical limitations imposed on current surgical systems to better treat an even wider range of illnesses with even greater effectiveness and much higher precision.

In reality, the robot is actually just one more tool Hopkins' faculty and students are adding to their already extensive arsenals. The mock OR was founded as a part of the Engineering Research Center, which got its start more than 10 years ago with the help of a grant from the National Science Foundation. The University is the lead institution of the ERC, and collaborates with the Hopkins hospital and medical school, Carnegie Mellon and the Massachusetts Institute of Technology.

Located in the tunnel through the CSEB building between the Decker and Wyman Quads, the mock OR is a state-of-the-art recreation of a real-life operating room, a set-up that Hopkins researchers hope to use to more effectively study surgeons at work in order to facilitate the creation of better and more advanced software programming to run robots like the Da Vinci surgical system.

That being said, the robot is not intended to be a replacement surgeon. The robot will not function unless an operator sits at the helm, peers into the eyepiece and manually maneuvers the robot's mechanical arms. "The operating room is getting smarter," Russell Taylor said, who is the director of the ERC CISST and one of the many Hopkins faculty members who work on and with the Da Vinci system. However, surgeons don't have to be too worried about looking for other jobs in the near future.

Though no live-patient surgeries are done in the mock OR, researchers (which include faculty and graduate students as well as undergraduates) at the Homewood campus recruit colleagues from the medical school to help in their investigation of the Da Vinci system.

"We have close working relationships with end users in the medical school - surgeons - who work with us," Taylor said. "The mock operating room is actually a systems integration laboratory in which the goal is to bring all of these components - imaging, robots and human interfacing - together to test it in a realistic environment."

Thus, scientists like Taylor can study how robots and humans come together in a surgical setting, which inevitably will help them to develop better software and fine-tune pre-existing surgical robotic systems for use in real operating rooms in the future. "We use plastic phantoms on which we can do much of the testing before doing live testing at the medical school," Taylor said.

By analyzing how these surgeons interact with and utilize the system, researchers like Taylor hope to develop computer-based systems to improve interventional methods, such as software that could enforce safety measures in case a surgeon gets a little too close to delicate tissue during a tricky procedure.

The greatest potential offered by the integration of surgical robots into more surgeries is their especially large capacities to integrate huge amounts of information. Theoretically, these robots can take database information (including anatomical atlases, etc.), combine it with individualized patient info (such as medical imaging results) to allow the surgeon to better analyze individual surgeries, making them safer and more efficient, which in turn allows patients to experience less painful, faster, and more efficient procedures and recoveries.

The research done within the CISST ERC framework is widely varied, but most focuses on enhancing the current technological surgeries; Taylor, for example, has lent his mind power to several different problems in the last several decades; he has worked not only here at Hopkins, but also at IBM, developing a surgical robotic system in the early nineties called Robodoc, which was used to increase the precision of hip implant surgeries.

And not only has he worked to advance surgical robotics, but he has also moved into the realm of mentorship of young undergraduate minds. Taylor teaches several classes on campus that apply to medical robotics, including those on computer-integrated surgery and medical imaging. "Our focus is on both research and education," he said.

http://media.www.jhunewsletter.com/media/storage/paper932/news/2009/10/29/ScienceTech/Da.Vinci.Robot.Future.Of.Surgery-3819099.shtml