San Jose Mercury News April 09, 2005
I, ROBOT -- AND SURGEON
Working Model 10 or 15 Years Away, Experts Estimate
By Margaret Steen
Imagine having surgery inside a small moving vehicle, with robotic arms cutting you open and sewing you up -- and no people in sight.
As the military looks for ways to cut labor costs and put fewer lives at risk, it is envisioning a mobile ``trauma pod'' in which injured soldiers are operated on by robotic arms under the control of surgeons who are far from the battlefield.
Enter SRI International, a non-profit research institution in Menlo Park. SRI leads a group that has won a $12 million contract to begin research on the trauma pod. The contract for a two-year preliminary project is from the Defense Advanced Research Projects Agency, the Defense Department's research and development group. Experts estimate that a working trauma pod is at least 10 or 15 years away.
``Think of a super-sized ambulance'' with robotic arms instead of emergency medical personnel, said John Bashkin, director of business development for SRI.
The initial goal is to create a remote-controlled system that can sew a mannequin's severed blood vessel back together. That particular task was chosen, Bashkin said, because it's common but requires a lot of manual dexterity.
The team doesn't have to start from scratch. It's using a commercially available computer-aided surgical system from Sunnyvale-based Intuitive Surgical, a company that was founded with SRI technology. The goal for the first phase, Bashkin said, is to automate everything else about the surgery: handing the proper tools to the surgeon's robotic arm, for example, or disposing of used gauze.
It's challenging to create a system that is partly under a faraway surgeon's control and partly automated, Bashkin said. For example, the robot that is handing tools to the surgeon's robotic arm needs to respond to the surgeon's commands but also know how to find a new tool and put the old one away by itself -- while making sure it doesn't collide with any other robotic arms.
``This is a very tight space around the surgical area,'' Bashkin said. ``The robot doesn't know exactly where the surgeon is going to be moving his hands.''
Another big task is figuring out the best way for the surgeons to communicate with the robots, Bashkin said. Surgeons need the patient's vital signs and other medical information; the robots need to be told what to do.
Finally, Bashkin said, the team needs to create a robot that can deal with the unexpected.
``If a robot goes to pick up a piece of gauze and it happens to fall on the floor because the truck goes over a big pothole, how do you recover from that error?'' he said.
The trauma-pod project is a continuation of several American military trends, said John Pike, director of GlobalSecurity.org, a defense information Web site in Alexandria, Va.
``It's said that war involves the sacrifice of blood and treasure,'' Pike said. ``It has always been the American style of war to substitute treasure for blood, and this is a continuation of that.''
The project would also represent further progress in trauma care on the battlefield, an area that has already seen significant improvements, Pike said. It used to be that the military would see one death for every three service members who were injured but survived. Today, it's one dead for every seven wounded.
But Pike said the most significant trend is one familiar to those in the private sector as well: Increased automation means lower labor costs.
If surgeons don't need to travel to the war zone, the military would need fewer people to transport them, cook their food and guard them, Pike said. The military could also get by with fewer surgeons if it could easily redirect surgeons from routine procedures in military hospitals to remote-controlled trauma surgery after a disaster.
If the SRI-led demonstration of the trauma pod is successful, Bashkin said, the group will discuss with DARPA funding for the next phase of the project, which could include trying to scale down the system to make it more portable.
Bigger challenges would be addressed in later phases of the work: getting a robot to insert an intravenous tube or administer anesthesia.
The research on these and other issues could have an impact on medicine even before a working trauma pod enters battle, Bashkin said. For example, in trying to automate the anesthesia process, researchers could learn more about how to make current anesthesia practices safer.
© Copyright 2005, San Jose Mercury News
