NSF PR 96-87 - December 19, 1996
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Robots, Virtual Reality & Other 'Smart' Tools
Soon Will Help Physicians Heal Patients
Voice-controlled surgical instruments; navigational
systems to guide surgical tools; three-dimensional
images projected onto patients in the operating room;
and physicians thousands of miles apart participating
in live surgery -- these are among early 21st century
technologies doctors and engineers are dreaming about
and developing now.
"We're encouraging close collaboration between engineers
and surgeons to rapidly develop research and technology
that can provide more precise information and procedures
in the doctor's office and the operating room," says
Gilbert Devey, a National Science Foundation (NSF)
program director in biomedical engineering. "We hope
soon to see new, sophisticated systems that physicians
can use to improve patient care and, in many cases,
even lower the cost of treatment."
Plans for new surgical simulations, image-guided therapies,
robotics and teleinterventions are described in a
new 135-page report, edited by Anthony M. DiGioia,
Takeo Kanade and Peter Wells. The report summarizes
the findings of the Second International Workshop
on Robotics and Computer Assisted Medical Interventions,
held in Bristol, England, June 23-26, 1996.
DiGioia directs the Center for Orthopaedic Research
at Shadyside Hospital in Pittsburgh. He and Kanade
co-direct the Center for Medical Robotics and Computer-Assisted
Surgery at Carnegie Mellon University. Wells is a
research director of radiologic services at Bristol
General Hospital, England.
Organized by DiGioia and supported by NSF, the workshop
convened 52 engineering, computer science and medical
researchers from seven nations, nominated by their
peers, to assess the status and research needs of
this rapidly advancing field.
"We are not talking about replacing physicians, but
providing them with more precise tools that take advantage
of physicians' skills," says DiGioia. "By coupling
the power of these emerging technologies with human
skills, we hope to improve our patients' outcomes.
Reducing complications and making procedures more
precise and less invasive should result in faster
recoveries and less need for repeat surgery," he says.
Support for the June workshop was provided by NSF,
the Defense Advanced Research Projects Agency (DARPA),
and various commercial partners, and hosted by the
United Kingdom's Engineering and Physical Science
Research Council. A follow-up workshop is being planned
for 1999.
Attachment: Selected Findings
from the Second International Workshop on Robotics
and Computer Assisted Medical Interventions
Editors: For the complete workshop report,
see: http://www.ri.cmu.edu/mrcas/rcami.html
Attachment
Selected findings: Second International Workshop on
Robotics and Computer Assisted Medical Interventions
June 23-26, 1996 - Supported by the National Science
Foundation
Surgical simulations in the future will produce more
than today's static pictures of a patient's hip or
heart. Tomorrow's three-dimensional images, digitized
from CT, MRI and ultrasound data, will be reactive.
They will give realistic, immediate visual and tactile
feedback to help physicians plan and test surgical
procedures -- especially highly precise implant, neural
and cranial-facial surgeries. A major challenge for
surgical simulation is to create a virtual human body
that will allow physicians and students not only to
learn about anatomy and physiology, but also to dissect,
simulate treatments, and predict outcomes of procedures
and situations, such as auto accidents. This new technology
is evolving from computer-aided design and modeling
(CAD/CAM) tools developed for aerospace and civil
engineering.
Image-guided therapies, or surgical navigation systems,
address ways to introduce surgical simulations and
precise pre-operative plans into the operating room,
and to relate them to the patient. Borrowing from
military targeting technology and video games, engineers
are creating ways for physicians to precisely position
implants or tools, or to locate tumors or other tissues,
by matching the cross hairs of a pre-operative simulation
that can be viewed on a monitor or projected directly
onto the patient during surgery.
Robotics research is leading to a wide range of passive
and active tools. Physicians want devices that can
hold laparoscopic cameras or other delicate equipment
during surgery with more precision and without human
fatigue; such devices might be controlled by voice
command or foot pedals. Other tools could: provide
accurate navigation through sensitive areas, such
as the brain; automate procedures such as precision
milling during hip surgery to perfect alignment and
improve natural bonding of bones to implants, reducing
complications; and, with computerized controls, augment
a surgeon's dexterity.
Teleintervention will go beyond simple two-way communication
with pictures; the aim here is to allow a surgeon
in an operating room to obtain live, interactive consultation
with one or more specialists miles away. Interactive
tools might allow consulting physicians to project
target points onto a patient to help direct the principal
surgeon's actions, or even to assist in operating
equipment by remote control. These technologies would
give people in rural areas more access to the skills
of specialists. Military officials are interested
in teleintervention to bring better emergency care
closer to the front lines without exposing the majority
of surgical teams to the risks of battle.
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