Telerobotics-assisted surgery to aid rural patients

Two doctors separated by nearly 400 km use telerobotics assistance to perform acid reflux operation

Canadians living in remote communities will now have access to the most advanced surgical procedures, thanks to telerobotics.

Surgeons at Hamilton's St. Joseph Healthcare centre assisted the surgical team at North Bay General Hospital in performing the world's first hospital-to-hospital telerobotics-assisted surgery in February.

Using Bell Canada's VPNe commercial networking service, Hamilton-based Dr. Mehran Anvari assisted Dr. Craig McKinley, a North Bay-based surgeon, in performing a laparoscopic Nissen fundoplication (acid-reflux) surgery over a distance of nearly 400 km.

At one end of the network, Anvari used the Zeus Surgical System, developed by Santa Barbara, Calif.-based Computer Motion. Bell's VPNe network then carried his hand, wrist and finger movements to the system's robotic arms residing in North Bay General Hospital's operating room. The network delivered information over 10 to 12 Mbps of bandwidth. It ensured that the delay between Anvari's movements and the robotic arms' movements controlling the endoscopic camera in the patient's abdomen was no longer than 150 milliseconds.

The VPNe is ideally suited for use in a surgical environment, Bell executives said, since the network is protected against both fibre cuts and laser failures. It has the ability to self-heal against failure within 50 milliseconds.

The experience felt like a real collaboration, McKinley said.

"I would say that the case went so well that it was as if Dr. Anvari was in the room with me performing the procedure," he said. "And ultimately the telecommunications link and the robotic hardware has made that feasible."

The technology is another step towards changing the face of health care for Canadians living in rural or remote communities, Anvari said.

"At present time, patients who live in remote and rural parts of the country, and that comprises about a third of the population, have access to the latest surgical care only if they travel to the big city hospitals, usually in the southern parts of Canada," he said.

Those patients do not generally have access to new surgical methods like minimal access surgeries that are much less invasive than traditional procedures and reduce recovery lime significantly. Anvari noted that thanks to telerobotics-assisted surgeries, the choice between a more invasive surgery and travelling to a large city may no longer be necessary. The project, however, depends on the availability of a high-performance network, something that the Canadian government has been trying to introduce to remote communities for some time. One of the challenges has been the price of implementing such a network. However, Bell Canada vice-president of enterprise data and managed services Charles Salameh said that the savings generated by shorter hospital stays, eliminating transfer cost and ultimately giving surgeons a reason to stay in rural communities make that cost a justifiable expense.

-ITBusiness.ca

Copyright Plesman Publications Ltd. Apr 2003
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