"There is a large community that is envisioning a robot that is deployable in an armored vehicle, much closer to combat, where an expert surgeon can remotely work on the patient very quickly after an injury is sustained", stated Dr. Blake Hannaford, a professor of electrical engineering and adjunct professor in bio-engineering and mechanical engineering at the University of Washington. "The kind of focus, as I understand it, is stopping arterial bleeding that's not amenable to a tourniquet and stabilizing that so that a soldier can be transported for regular care."
Dr. Hannaford and his team have created a surgical robot that works on a patient's abdomen. It has two arms, and a motorized carriage on the operating table lets the arms move anywhere on the table. "It's very position-able to any part of the body", he stated, adding that this may possibly allow the robot be used on arms and legs.
Dr. Hannaford's research endeavours were funded, in part, by a grant from the DoD's Peer Reviewed Medical Research Programme. Congress created the programme in 1999 to promote research in health issues the military faces. Since its inception through 2005, the programme has spent almost $300 million to fund nearly 200 projects in a range of medical topics, including combat casualty care and technology and infectious disease research.
Along with Dr. Hannaford, Drs. Jacob Rosen, Mika Sinanan and Richard Satava are also co-investigators on the grant. "We're established in this area because of this grant", he stated. "There's a good chance we wouldn't be in this field if not for this grant."
Dr. Hannaford didn't set out to create a robot. His initial grant, from the Defense Advanced Research Projects Agency, was to measure surgeons' movements and develop a way to evaluate their skills statistically with software. "Surgical training is modelled like a medieval apprenticeship. You go to med school and then you have a residency where you hang out with a surgeon and watch, and they let you help out a little bit and you try more and more parts of the operation", he stated. "It isn't formalized. There aren't official milestones for each year."
After completing that research, Dr. Hannaford took his data on surgeon movement and crafted his robot. Renowned telesurgeon Dr. Tim Broderick put the robot through its paces June 3-11 in Simi Valley, California. Via a communications link that was bounced off an unmanned aerial vehicle, Dr. Broderick operated Dr. Hannaford's robot first from the valley and then from Seattle.
The desert experiment was a success, stated Dr. Gerry Moses of the Telemedicine and Advanced Technology Research Center, which also funds part of Dr. Hannaford's research. "It encountered some challenges with the communications link, but there were no considerable technical challenges. In fact, this gave us a road map of what we need to work on next", he stated.
Not having surgical expertise in remote areas is not just a military issue, Dr. Hannaford noted. The University of Washington in Seattle is the only medical school in five states and has patients who hail from Alaska, Montana, Idaho and Wyoming.
"There are patients in Alaska who are 1700 miles from Seattle. If their little clinic can't handle the problem, they come all the way to Seattle. Some patients might be resistant to the idea of robotic telesurgery at first, but surgeons have found many patients receptive to the technology, and if they can be taken care of in their own community, there's a benefit", he stated.
For example, a surgeon in Canada, Dr. Mehran Anvari, has conducted more than two dozen robotic telesurgeries via the Canadian telephone system on patients who were 250 miles away. Robotic telesurgery may also bring specialized surgical skills to military field hospitals where they may be in short supply.
Neither Dr. Hannaford nor Dr. Moses say that robotic telesurgery will be on the battlefield next month or next year but they do believe that with hard work it will be there in the not-too-distant future. "We're not talking about something that's going to be immediately available, but if we don't do this research now, we will not have the option of having surgical intervention remotely or robotically on the battlefield", Dr. Moses stated.
For more information, you can visit the DoD's Peer Reviewed Medical Research Programme.