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A Military Perspective Future of Telepresence Surgery. of the. Richard M. Satava, MD FACS Professor of Surgery University of Washington. Telepresence World 2007 La Jolla, CA June 4, 2007. Presenter Disclosure Slide. Richard M. Satava, MD FACS InTouch Health, Inc Karl Storz

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Presentation Transcript
slide1

A Military Perspective

Future of Telepresence Surgery

of the

Richard M. Satava, MD FACS

Professor of Surgery

University of Washington

  • Telepresence World 2007
  • La Jolla, CA
  • June 4, 2007
slide2

Presenter Disclosure Slide

Richard M. Satava, MD FACS

InTouch Health, Inc

Karl Storz

METI, Inc

Premiera BC/BS

Stryker

SimuLab

US Surgical

slide3

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”

slide5

Information basis for surgery

Borrow from Industry - CAD/CAM

Follow military research projects

The Fundamental Changes

slide6

From tissue and instruments

to

Information and energy

The Fundamental Concept

slide7

Holomer

Total body-scan to “replace” patient

  • Holomer is the CAD/CAM model of patient
  • Pre-operative planning
  • Surgical Rehearsal (including ‘editing’)
  • Intra-operative navigation and image guidance
  • Automation of procedure
  • Post-op comparison (objective assessment & outcomes analysis)
slide8

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

total integration of surgical care

Minimally Invasive Surgery

Remote Surgery

Pre-operative planning

Intra-operative navigation

Total Integration of Surgical Care

Simulation & Training

Joel Jensen,

SRI International, Menlo Park, CA

seeing touching tissue with imaging mechanical instruments with energy

HIFU

High Intensity

Focused Ultrasound

for

Non-invasive

Acoustic hemostasis

Replacing

seeing/touching tissue with imagingmechanical instruments with energy
  • Changes tissue to information
  • Changes mechanics to energy
  • Simultaneous Dx & Rx

Courtesy Larry Crum, Univ Washinton Applied Physics Lab, 1999

slide12

Trans Oral Intra-peritoneal Surgery - Future

Courtesy of N Reddy, Hyperbad India 20005

peroral transgastric endoscopic surgery natural orifice transluminal endoscopic surgery notes
Peroral Transgastric Endoscopic SurgeryNatural Orifice Transluminal Endoscopic Surgery (NOTES)

Mechanical (prehistoric) instrumentation

Courtesy of N Reddy, Hyperbad India 20005

slide14

Future of

Endoscopic and NOTES:

A Surgical Workstation?

Conventional colonoscopy and NOTES

[ Courtesy R Satava, GI Clinics North America, 1983]

DaVinci Surgical Workstation

slide16

ROBOT SURGICAL TECHNOLOGIES, INC

“Penelope” – robotic scrub nurse

Michael Treat MD, Columbia Univ, NYC. 2003

Currently in Clinical Trials

slide17

Integrating Surgical Systems for Autonomy

The Operating Room (personnel) of the Future

100,000

Surgeon Scrub Nurse Circulating nurse

Satava March, 2000

slide21

Predator 2003

Fighter Pilots – until 2002

Fighter Pilots – Beyond 2003

SATAVA 7 July, 1999

DARPA

slide22

“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

28 Training & Simulation Journal August/September 2006

slide24

Tissue Engineering

Artificial Ear

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

J. Vacanti, MD MGH March, 2000

slide25

Femtosecond Laser

(1 x 10 –15 sec)

Los Alamos National Labs, Los Alamos NM

Time of Flight Spectroscopy

Cellular opto-poration

Cold Spring Harbor Laboratory, Long Island, NY

slide26

Surgical console for cellular surgery

Courtesy Prof Jaydev Desai, Drexel Univ, Philadelphia, PA 2005

slide27

Surgical console for cellular surgery

Motion

Commands

Courtesy Prof Jaydev Desai, Drexel Univ, Philadelphia, PA 2005

slide30

Planet Earth

Represented as a 4-D structure

http://depts.washington.edu/biointel

Do Robots Dream ?

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