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Telepresence World 2007 La Jolla, CA June 4, 2007 A Military Perspective Future of Telepresence Surgery Richard M. Satava, MD FACS Professor of Surgery.

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Presentation on theme: "Telepresence World 2007 La Jolla, CA June 4, 2007 A Military Perspective Future of Telepresence Surgery Richard M. Satava, MD FACS Professor of Surgery."— Presentation transcript:

1 Telepresence World 2007 La Jolla, CA June 4, 2007 A Military Perspective Future of Telepresence Surgery Richard M. Satava, MD FACS Professor of Surgery University of Washington of the

2 Presenter Disclosure Slide Richard M. Satava, MD FACS InTouch Health, Inc Karl Storz METI, Inc Premiera BC/BS Stryker SimuLab US Surgical

3 Battlefield Surgery – Initial Premise - 1992 Bring the operating room to the wounded soldier, not the casualty to the OR Change the “Golden Hour” into ….. the “Golden Minute”

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5 Information basis for surgery Borrow from Industry - CAD/CAM Follow military research projects The Fundamental Changes

6 From tissue and instruments to Information and energy The Fundamental Concept

7 Holomer Total body-scan to “replace” patient Holomer is the CAD/CAM model of patient 1.Pre-operative planning 2.Surgical Rehearsal (including ‘editing’) 3.Intra-operative navigation and image guidance 4.Automation of procedure 5.Post-op comparison (objective assessment & outcomes analysis)

8 Why robotics, imaging and modeling & simulation Healthcare is the only industry without a computer representation of its “product” A robot is not a machine... it is an information system with arms... A CT scanner is not an imaging system it is an information system with eyes... thus An OR is an information system with... The key to total integration is through Information Systems That is the secret of the Information Age

9 Total Integration of Surgical Care Joel Jensen, SRI International, Menlo Park, CA Minimally Invasive Surgery Pre-operative planning Intra-operative navigation Remote Surgery Simulation & Training

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11 seeing/touching tissue with imaging mechanical instruments with energy Courtesy Larry Crum, Univ Washinton Applied Physics Lab, 1999 Changes tissue to information Changes mechanics to energy Simultaneous Dx & Rx High Intensity Focused Ultrasound for Non-invasive Acoustic hemostasis HIFU Replacing

12 Trans Oral Intra-peritoneal Surgery - Future Courtesy of N Reddy, Hyperbad India 20005

13 Peroral Transgastric Endoscopic Surgery Natural Orifice Transluminal Endoscopic Surgery (NOTES) Mechanical (prehistoric) instrumentation

14 DaVinci Surgical Workstation Conventional colonoscopy and NOTES Future of Endoscopic and NOTES: A Surgical Workstation? [ Courtesy R Satava, GI Clinics North America, 1983]

15 So What ?

16 “Penelope” – robotic scrub nurse Michael Treat MD, Columbia Univ, NYC. 2003 ROBOT SURGICAL TECHNOLOGIES, INC Currently in Clinical Trials

17 Integrating Surgical Systems for Autonomy The Operating Room (personnel) of the Future Satava March, 2000 Surgeon Scrub Nurse Circulating nurse 100,000

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20 The Operating Room of the Future

21 SATAVA 7 July, 1999 DARPA Fighter Pilots – until 2002 Fighter Pilots – Beyond 2003 Predator 2003

22 28 Training & Simulation Journal August/September 2006 “Remote Pilots” A last bastion of guts-and-glory aviation is falling, as the U.S. Air Force prepares to unveil a new breed of unmanned aircraft pilots. Known as “remote pilots”, they’ll wear wings. They’ll fly aircraft. But chances are many will never climb into a cockpit.. Senior leaders have yet to approve the new Undergraduate Remote Pilot Training (URT), but Air Force officers familiar with the project expect approval by the end of the year. Instead of sticking reluctant manned aviators behind a console, the Air Force will groom remote pilots from the start to fly what the service now calls unmanned aerial systems

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24 Tissue Engineering Liver Scaffolding Artificial Blood Vessel Atala A, Bauer SB, Soker S, Yoo JJ, Retik AB.Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet (2006) Apr 15; 367: 1215-6 Artificial Ear J. Vacanti, MD MGH March, 2000

25 Cold Spring Harbor Laboratory, Long Island, NY Femtosecond Laser (1 x 10 –15 sec) Time of Flight Spectroscopy Cellular opto-poration Los Alamos National Labs, Los Alamos NM

26 Surgical console for cellular surgery Courtesy Prof Jaydev Desai, Drexel Univ, Philadelphia, PA 2005

27 Surgical console for cellular surgery Courtesy Prof Jaydev Desai, Drexel Univ, Philadelphia, PA 2005 Motion Commands

28 Surgical Cockpit

29 Thoughts into Action

30 Do Robots Dream ? http://depts.washington.edu/biointel

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