1. A New Generation of Surgical Technique: Telesurgery Using Haptic Interfaces By Sarah L. Choy ~ A haptic interface is a force reflecting device which allows a user to touch, feel, manipulate, create and/or alter simulated objects in a virtual environment. The nature of haptic interfaces allows a surgeon to sense human tissue by means of force feedback, which is sent via a high-speed network.

2. What is a Haptic Interface? Haptic comes from the Greek meaninghaptesthai, to touch Human-robot interaction to support physical manipulation of computer simulated objects Haptic interface comprises of : Manipulandum: operator handle, sensors Haptic Display: mechanical, electrical and computer hardware

3. Force Feedback Force Feedback: Devices that interact with muscles and tendons giving the sensation of force is being applied Multi force transducers Strain Gauges

4. What is Telesurgery? Surgery via long-distance communication links Telesurgical workstation restores manipulation and sensation capabilities of surgeon Robot controlled through master will restore dexterity and force feedback in real time Will allow professional surgeons to perform complex procedures with higher precision overseas without leaving their office Instruments designed to enter the body cavity through (usually 3) incisions of merely 1 cm in length

5. From Physical to Mechanical Surgeon: In multimedia cockpit equipped with stereoscopic screen and master manipulators that sends control pulse to real-time controller Information is sent via communication link (LAN, ATM, satellite communication, etc.) to surgical site Robot: Information is received at the surgical site through a real-time controller and is inputted into slave manipulators, which perform surgery on patient Feedback information is sent back via communication link (back through real-time controllers) which in turn affect master manipulators Throughout: Endoscope sends visual information via communication link from robot to multimedia cockpit

6. Haptic Interfaces: Feedback Channels Force feedback: Man-machine interface that directly connects surgeons hands to motion of his surgical tool tips inside patients body Visual feedback Visual feedback provided by endoscope camera which transports 3D images in the same orientation as master controller and monitor

7. The da Vinci and Zeus Surgical Systems 7 degrees of freedom: 3 x orientation + 3 x translational + grip Filters out surgeon tremor making tool tip steadier than unassisted hand Voice control allows surgeon to guide endoscope

8. From the Past to Present: What the Future Holds 1999: ZEUS made history in the world's first robotic-assisted beating-heart bypass surgery September 2001: a surgeon in New York performed gallbladder surgery on a 68-year-old patient in Strasbourg, France. September 2002: ZEUS was granted clearance by Health Canada in October 2002 for cardiac surgery and telesurgery applications Eventually doctors may be able to use this technology to operate on patients in dangerous or inaccessible locations with the development of improved high-speed networks Use of tactile feedback, sensing heat and other textures Use of optoelectronic sensors instead of metal strain gauges

9. References: Cavusoglu, Cenk, M., et al. 2001. Robotics for Telesurgery: Second Generation Berkeley/UCSF Laparoscopic Telesurgical Workstation and Looking Towards Future Applications. Proceedings of 39 th Allerton Conference on Communication, Control and Computing. Centre for the Integration of Advanced Medicine and Innovative Technology. 2003. Future Perspective. Website Accessed: February 10, 2004 Computer Motion. 2002. Zeus® Surgical System. Website Accessed: February 10, 2004 Guthart, Gary S. and Salisbury, Kenneth J. Jr. 2000. The IntuitiveTelesurgery System: Overview and Application. Pro. IEEE. ICRA. Intuitive Surgical Inc. 2003. da Vinci Surgical Systems. Website Accessed: February 10, 2004 Mitsuishi, Mamoru, et al. 2003. Development of a Remote Minimally-Invasive Surgical System with Operation Environment Transmission Capability. Pro. IEEE. ICRA. Tavakoli, M., et al. 2003. A Force Reflective Master-Slave System for Minimal Invasive Surgery. Pro. IEEE. International Conference on Intelligent Robots and Systems.