Transcontinental Telesurgical Nephrectomy Using the da Vinci Robot in a Porcine Model

Sterbis, Joseph R.; Hanly, Eric J.; Herman, Barry; Marohn, Michael R.; Broderick, Timothy J.; Shih, Samuel P.; Harnett, Brett; Doarn, Charles R.; Schenkman, Noah S.

doi:10.1016/j.urology.2007.11.027

Cited by 88 publications

(55 citation statements)

References 7 publications

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“…9,10 Studies in the adult population have so far been mainly limited to the application of remote telesurgery, with the advent of robotic surgical systems. 11,12 Some small, single-centre studies of the adult urological population and telemedicine in the U.S. have so far shown good patient/provider satisfaction and success. [13][14][15][16] There are no reports of using provider-to-provider eConsults in urology.…”

Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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Introduction: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Methods: Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed. Each consult was characterized in regard to the type of question asked by the referring physician and the clinical content of the referral. Using the mandatory close-out surveys, we analyzed rates of referral avoidance, physician satisfaction, and overall impact on patient care. Results: Of 190 eConsultations, 70% were completed in less than 10 minutes. The most common clinical questions related to the interpretation of imaging reports (16%) and tests to choose for investigating a condition (15%). The most common diagnoses were hematuria (13%) and renal mass (8%). In 35% of cases, referral to a urologist had originally been contemplated and was avoided. In 8% of cases, a PCP did not believe a consultation was initially needed, but a referral was ultimately initiated after the eConsultation. Conclusions: Our study shows that although certain clinical presentations still require a formal in-person urological consultation, eConsultations can potentially reduce unnecessary clinic visits while identifying patients who may benefit from early urological consultation. Through both these mechanisms, we may improve timely access to urologists.

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Section: Introductionmentioning

confidence: 99%

Improving access to urologists through an electronic consultation service

Witherspoon

Liddy²,

Afkham³

et al. 2017

CUAJ

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“…Remote surgeons may be confronted with considerable time delay (500-900 ms) in the absence of dedicated fibre-optic lines (4)(5)(6)(7). We demonstrated in a previous study that simple telesurgical procedures remain possible with a delay up to 700 ms (8).…”

Section: Introductionmentioning

confidence: 76%

Effect of latency training on surgical performance in simulated robotic telesurgery procedures

Perez

Yang

et al. 2014

Int J Med Robotics Comput Assist Surg

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“…In 2005, TATRC presented collaborative telerobotic surgery (four nephrectomies on a porcine model) with modified da Vinci consoles, being able to overtake the control of one with the other through a public Internet connection [16]. During the experiment, the average roundtrip latency was 450 ms from Denver to Sunnyvale and 900 ms from Cincinnati to Sunnyvale, which degraded the performance of the physicians [6]. The Canadian Surgical Technologies and Advanced Robotics (CSTAR) in London (Ontario, Canada) used Bell Canada's core network to test the telesurgery-enabled version of the da Vinci.…”

Section: Commercialized Surgical Robot Systemsmentioning

confidence: 99%

“…MIS is considered to be one of the most important breakthroughs in medicine in the past decades, and the technology keeps developing in many new directions [5]. The first human telesurgery consultation was reported in 1996, and in 2000, completely remote telesurgical animal trials were conducted [6]. In 1997, laparoscopic colectomy and laparoscopic Nissen fundoplications were the first procedures performed with the aid of professional telementoring from over 8 km away [3].…”

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confidence: 99%

Surgery in space: the future of robotic telesurgery

2010

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Background The origins of telemedicine date back to the early 1970s, and combined with the concept of minimally invasive surgery, the idea of surgical robotics was born in the late 1980s based on the principle of providing active telepresence to surgeons. Many research projects were initiated, creating a set of instruments for endoscopic telesurgery, while visionary surgeons built networks for telesurgical patient care, demonstrated transcontinental surgery, and performed procedures in weightlessness. Long-distance telesurgery became the testbed for new medical support concepts of space missions. Methods This article provides a complete review of the milestone experiments in the field, and describes a feasible concept to extend telemedicine beyond Earth orbit. With a possible foundation of an extraplanetary human outpost either on the Moon or on Mars, space agencies are carefully looking for effective and affordable solutions for lifesupport and medical care. The major challenges of surgery in weightlessness are also discussed. Results Teleoperated surgical robots have the potential to shape the future of extreme health care both in space and on Earth. Besides the apparent advantages, there are some serious challenges, primarily the difficulty of latency with teleoperation over long distances. Advanced virtualization and augmented-reality techniques should help human operators to adapt better to the special conditions. To meet safety standards and requirements in space, a three-layered architecture is recommended to provide the highest quality of telepresence technically achievable for provisional exploration missions. Conclusion Surgical robotic technology is an emerging interdisciplinary field, with a great potential impact on many areas of health care, including telemedicine. With the proposed three-layered concept-relying only on currently available technology-effective support of long-distance telesurgery and human space missions are both feasible.

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Transcontinental Telesurgical Nephrectomy Using the da Vinci Robot in a Porcine Model

Cited by 88 publications

References 7 publications

Improving access to urologists through an electronic consultation service

Improving access to urologists through an electronic consultation service

Effect of latency training on surgical performance in simulated robotic telesurgery procedures

Surgery in space: the future of robotic telesurgery

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