Socrates surgical mentor allows surgeon experts to provide remote guidance in complex procedures

Santa Barbara 08 March 2001A team of surgeons in the London Health Sciences Centre (LHSC), located in Ontario, Canada has performed the world's first series of tele-collaborative surgeries using the Socrates Tele-collaborative System designed by Computer Motion Inc., a pioneer in medical robotics. To date, a total of six robotically assisted procedures have been completed using the surgical mentor tele-collaborating system from the London University campus, with the operative surgeon actually performing the procedure at the Westminster campus, some 15 miles away.


The Socrates Tele-collaborative system allows surgeons to learn complex new techniques and draw on expert support, without having their teacher in the same operating theatre. In this way, Dr. Douglas Boyd, Dr. Alan Menkis and Dr. Reiza Rayman completed a mitral valve repair and two heart bypass surgeries. Dr. Brian Taylor and Dr. Winston Hewitt performed an appendectomy procedure, whereas Dr. Richard Inculet, together with Dr. Richard Malthaner, completed a lung biopsy and a lung resection procedure.

One of the most effective methods for surgeons to learn new procedures is directly from another surgeon. As a result, surgeon champions are routinely called upon to lend their clinical expertise and direction to surgeons who are still gaining expertise in advanced or complex procedures. Often, there are travel costs and scheduling challenges associated using this scenario. There has been an increasing interest in finding a better way to economically and effectively augment minimally invasive and conventional "open" surgical training.

Standard teleconferencing systems are proving to be inadequate to the task of transmitting a clear, steady, non-pixelated operative image for the remote surgeon. The Computer Motion Socrates system eliminates these and other problems. Socrates provides the remote surgeon access to a precise, stable image via Computer Motion's Aesop Endoscope Positioner while adding much more features.

Yulun Wang, Ph.D., the founder and CTO of Computer Motion, commented: "Computer Motion has taken telecommunications one important step further by developing the Socrates system to eliminate the distance barrier for physical interaction, enabling a novel class of training and education required for the advancement of open and endoscopic surgical techniques. In the late 1980s and early 1990s when the medical community realised the full significance of laparopscopy for patients, thousands of surgeons had to learn new surgical techniques. This situation is repeating itself as emerging technology is enabling innovative advanced surgical procedures that yield improved patient outcomes across a broad range of surgical disciplines. We now sit on the threshold of another training and education opportunity, and Computer Motion is uniquely positioned to facilitate the necessary transfer of knowledge with our Socrates, Aesop and Hermes technologies."

"Socrates is a huge step beyond just sharing audio and video feedback via teleconference", added Dr. Ken Harris, Chief of Surgery at LHSC. "For the first time, the mentoring surgeon is able to actively participate in a hands-on manner from a remote location. This translates to a very economical and effective method to shorten the learning curve for surgeons applying new surgical techniques to their practice. Socrates equally facilitates the expansion of minimally invasive surgery into areas which may not currently have access to or the budget for surgical experts. And patients around the world will benefit from it."

LHSC is comprised of three separate sites across the city of London, Ontario. According to Tony Dagnone, President and Chief Executive Officer at LHSC, the positive impacts to patient care delivery as a result of the telementoring approach are astounding. "We believe the Socrates technology will someday mean patients will be able to access the care they need closer to home in their community hospitals. Beyond our region, this technology will equally allow us to share with and learn from other world-class health care providers. LHSC is committed to pursuing robotically assisted surgeries because we are convinced it is in the best interest of patients for improved outcomes and quality of life", Mr. Dagnone added.

Early development work on Computer Motion's telerobotic systems began in 1996 when Johns Hopkins University, under the direction of Dr. Louis Kavoussi, pioneered the development of telerobotics with Computer Motion's first telerobotic system, the Aesop 1000 TS. Johns Hopkins was the first institution to use Computer Motion's telerobotic system in multi-centre U.S. and transcontinental clinical trials. Dr. Kavoussi and a number of notable surgeons, including Dr. Peter Schulam of the University of California, Los Angeles Medical Center, published their initial telerobotic experience and continue to work with the technology today.

Several other world-class institutes, including the Medical College of Virginia and the Medical University of South Carolina, have partnered with Computer Motion in the development and testing of Socrates. The telementoring system is currently under regulatory review at the US Food and Drug Administration (FDA). "Computer Motion has designed and is continuing to expand its suite of products to enable improved minimally invasive surgical procedures, and to provide an effective training and education pathway to have surgeons evolve their techniques", Dr. Wang concluded. More information about the different robotic surgery systems which are currently being utilised in Europe and the USA, is available in the VMW July 2000 article Computer Motion to start patent infringement war on medical robotics against Intuitive Surgical.

Leslie Versweyveld

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