His name is Zeus. He rules his domain with an iron fist.
But he’s not a Greek god. He’s not human, either.
He’s your new surgeon.
Zeus is the new star in a line of surgical robots built by former UCSB Ph.D. student and engineering Professor Yulun Wang and his Goleta-based company, Computer Motion Inc. This summer, surgeons in New York, Dr. Jacques Marceaux and Dr. Michel Gagner, used a satellite link to operate Zeus by remote control, successfully removing the gallbladder of a patient in Strasbourg, France — 4,000 miles away.
“The goal of the project was a proof of concept,” said project director Moji Ghodoussi. “To show that we can have a large separation between the surgeon and the patient and still do a surgical procedure successfully.”
The procedure, christened Project Lindbergh, is the first of a new kind of medical procedure known as telesurgery.
“Zeus is a change in paradigm for the surgeon, who would normally stand by the patient,” said Wang. “Now the surgeon sits at a console away from the patient and performs the manipulations of the surgical instruments via robots through extended joysticks.”
Though it had never been attempted before, it was previously thought that such a procedure could only be performed over a distance of 200 miles, said Ghodoussi, who also received his Ph.D. in robotics from UCSB.
“Clearly we pushed that boundary quite a bit,” he said.
Even with humans at the helm, the idea of a robot surgeon may be a bit unsettling. However, Computer Motion’s robots make possible a form of medical procedure known as minimally invasive surgery or “laparoscopy.”
Rather than cutting open a patient from the nape of the neck to the navel to perform open heart surgery, laparoscopy makes it possible for surgeons to make tiny incisions and insert a small tube into the patient through which they can insert remote-controlled tools.
“The drive to minimally invasive surgery is a very powerful force going on in surgery today,” said Wang. “It makes perfect sense. People don’t want to be cut wide open to be fixed, if they can just be fixed through little tiny holes. Robotics is a new technology, which can help to drive minimally invasive surgery forward.”
Technicians at Computer Motion were quick to realize that if a surgical robot could be controlled from across a room, it might be controlled from larger distances as well. This, Wang said, comes with many additional advantages.
“If you needed a hernia repaired, it would be a very simple procedure to have here in Santa Barbara,” he said, “But it would require expertise probably way beyond the capability of many parts of Africa. This could enable that kind of thing to take place.”
[The Spirit of Goleta]
“Here’s where the challenge comes,” said Ghodoussi. “To make sure that the system still operates with the same feel and touch. In addition to that, that it still gives you the same safety features that a standard system has with all those checks and balances. And the system still had to operate properly over thousands of miles of separation.”
In order to perform a telesurgery, Computer Motion teamed other companies with different areas of expertise.
France Telecom, a French telecommunications company, provided live video feed from France to New York and a remote linkup between the surgeons’ joysticks and the robot in the opposite direction, all with a total lag-time of 200 milliseconds. Any flaw in either signal could be deadly.
Marceaux and Gagner of the Institute for Research into Cancer of the Digestive System were familiar with the standard Zeus robot and were responsible for performing the surgery.
Once all of the parts of the telesurgery system were in place, the surgeons performed six surgical procedures on animals over the course of two days in order to test the system.
“At that point we felt very confident that everything would be ready to go,” said Ghodoussi. “Of course, until you finish something like this, you don’t know how it will go.”
On September 20, 2001, Computer Motion and its partners announced the successful completion of the world’s first telesurgery.
[In the Beginning…]
Computer Motion Inc. opened its doors in 1989. Its founder, Yulun Wang had received his bachelor’s degree and his Ph.D. from UCSB before staying on to teach for a short time.
UCSB engineering Professor Steven Butner was Wang’s thesis advisor and currently works as a technical advisor for Computer Motion.
“Yulun was always highly motivated and imaginative,” Butner said. “His enthusiasm infected others and when he finished his Ph.D., he wanted to start his own company immediately.”
The first product produced by Computer Motion was a robot named Aesop, which the Food and Drug Administration licensed in 1993. Aesop, a remote-controlled camera used in laparoscopy, is still in production today. The camera sends a video signal from inside the patient being operated on, allowing surgeons to do highly technical procedures without cutting a patient open to view the surgical site.
Computer Motion’s next robot, Socrates, is also a remote-controlled camera and includes a remote telestration feature. Telestration is the ability to draw on a television screen using a special stylus pen; a feature commonly used in TV football games.
In surgery, telestration is useful as a teaching tool. While a new surgeon is performing a procedure, a more experienced surgeon can use Socrates to point the camera in the right direction and then draw instructions on the television screen the new surgeon is watching.
The biggest advantage is that the experienced surgeon can do this from anywhere in the world, meaning that any new surgeon can have access to an expert’s instruction.
“If you can have an expert beamed in to help the surgeon with their learning curve, it makes things safer for the patient,” said Wang. “Most injuries occur while the surgeon is on their learning curve. It’s kind of like having a copilot or doing driver’s training.”
In addition, Socrates could make it easier for surgeons everywhere to learn the newest procedures, giving everyone access to the latest medicine.
All the robots are controlled by Computer Motion’s own state-of-the-art operating system named Hermes. Hermes is voice operated, meaning that a surgeon can speak into a microphone and tell the robot what to do.
Computer Motion’s latest remote-controlled robot is Zeus, which in addition to being a camera is capable of performing an actual surgical procedure. Although it was designed for use in a normal operating room, Zeus is also the robot that makes telesurgery possible, opening a new frontier in medicine.
“In the near future,” said Ghodoussi, “We can provide care to people wherever they are. The distance barrier is removed forever. Now wherever you are, you can have access to any surgeon around the world.”