Robots, Virtual Reality & Other 'Smart' Tools Soon Will Help Physicians Heal Patients
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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.
Editors: For the complete workshop report, see: http://www.ri.cmu.edu/mrcas/rcami.html
-NSF-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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