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Telepresence World 2007 La Jolla, CA June 4, 2007

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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Telepresence World 2007 La Jolla, CA June 4, 2007

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  1. 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

  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”

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

  5. From tissue and instruments to Information and energy The Fundamental Concept

  6. 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)

  7. 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

  8. 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

  9. 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

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

  11. Peroral Transgastric Endoscopic SurgeryNatural Orifice Transluminal Endoscopic Surgery (NOTES) Mechanical (prehistoric) instrumentation Courtesy of N Reddy, Hyperbad India 20005

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

  13. So What ?

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

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

  16. The Operating Room of the Future

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

  18. “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

  19. 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

  20. 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

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

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

  23. Surgical Cockpit

  24. Thoughts into Action

  25. Planet Earth Represented as a 4-D structure http://depts.washington.edu/biointel Do Robots Dream ?

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