Surgeon Uses Robot Developed at UCLA to Remotely Teach Surgical Techniques at Eisenhower Medical Center near Palm Springs
By Rachel Champeau
A UCLA team of doctors and engineers has developed a new robot to help provide hands-on instruction to novice surgeons in minimally invasive surgical techniques — even if teacher and student are miles apart.
In one of the first tests with the robot, the team from UCLA connected remotely over the Internet to students more than 100 miles away at the Eisenhower Medical Center near Palm Springs.
Using dual controls similar to those used in a driver’s education car, Dr. Erik Dutson, a surgeon with UCLA’s Center for Advanced Surgical and Interventional Technology (CASIT), manned a master console to guide novices over the Internet as they took turns using a duplicate set of surgical tools. The center is part of the David Geffen School of Medicine.
During exercises to help them develop dexterity with the tools, novices practiced picking up rubber beads, tying a knot similar to those used in suturing and cutting out a cloth circle to simulate snipping tissue. Successful execution of such tasks is part of the certification process for surgical training.
Rather than picking up a scalpel, surgeons are now doing many procedures by using joystick-like controls that manipulate surgical instruments inserted through tiny, keyhole-size incisions. These newer techniques are popular because they provide a shorter recovery time for the patient, reduced pain and trauma, and a greater range of motion and access for the surgeon.
But as the demand for these new techniques grows, so does the need for more effective ways to teach these skills.
The remote robotic teaching system is one of the first to be developed to help surgeons feel resistance to bone and tissue as if they were operating inside the body, Dutson said. Even though he was miles away, Dutson could take over the controls and increase or relax the resistance that the trainee encounterd while performing the tasks. The trainee and Dutson talked to each other via a Skype-like interface on a monitor set up next to the robot platform. The robot also utilizes standard laparoscopic tools surgeons use in the operating room.
Called the LapaRobot, the new system was developed by a faculty member and researchers from the Department of Mechanical and Aerospace Engineering at the UCLA Henry Samueli School of Engineering and Applied Science in collaboration with the medical school. Professor and department chair Tsu-Chin Tsao conceived of the system, which was then designed and built by engineering researchers Stephen Prince and Chris Lim, with the help of colleagues Chris Kang and Kevin Chu. All are from UCLA’s Mechatronics and Controls Laboratory.
“These remote applications greatly broaden teaching and training capabilities,” said Dutson, CASIT’s executive medical director and associate clinical professor of surgery. Combat surgeons working on the battlefield as well as physicians in rural areas of the country or in third-world countries may someday be learning these skills remotely. “Telehealth is going to play a major role in the future of health care delivery,” he said.
Created with this in mind, the robot is portable, ergonomically adjustable and requires just one AC power plug and two Internet connections. “The goal was to create a unit that was easy to set up and utilize in a variety of locations,” Dutson said.
While the system is cost-effective, it has the reliability and stability required for tele-mentoring, said Tsao. “Such academic collaborations bring the latest engineering innovations and technologies into medicine to help advance the field, including developing new ways to train and educate.”
The teaching exercise with Eisenhower Medical Center is just one of a series of projects to assess the effectiveness of the robot in various training scenarios.
“It’s very gratifying to see the robot in action,” added Prince. “We’re excited to be able to contribute to this growing field of telemedicine.”