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January 30, 2006
Surgeon trains colleagues remotely through telerobotics

BY lance skelly

From a vantage point directly behind surgeons practicing an advanced laparoscopic procedure in Strasbourg, France, an Emory doctor recently conducted one of the world’s first telerobotic surgical-training sessions—from his office in Atlanta.

Daniel Smith, W. Dean Warren Professor of Surgery and chief of general and gastrointestinal surgery in the School of Medicine, used a mobile robot located in the largest surgery-training center in Europe to mentor and train two surgeons from Venezuela.

The ability to teach surgeons using telerobotics, Smith said, opens a significant door to surgical training; now, doctors can teach physicians around the world, or even in remote areas of the United States, without having to be physically present in the operating room.

“This has incredible implications for teaching surgeons, especially if we can have experts remain home in their own hospitals while still able to provide training resources in remote locations,” Smith said. “We are developing similar programs in Shanghai and Hong Kong.”

Smith uses an RP (Remote Presence)-6 robot, developed by InTouch Health, which can be remotely controlled by physicians via standard high-speed Internet connections. Through proprietary communications and the robot’s mobile platform, the controlling physician can be virtually “projected” to other locations
to interact with patients and caregivers, while participating in the treatment process and reviewing X-rays, medical records and lab reports—all in real time.

Caregivers, surgeons and patients can even speak “face to face” with the remote physician as the controlling doctor’s live, real-time image appears on a flat-panel monitor where the robot’s “head” would be. This technology allows the controller to remotely coach and train staff, leveraging the time and expertise of health care professionals while improving the efficiency and effectiveness of care delivery.

Emory faculty and researchers have been on the forefront of virtual training for the past eight years. The Emory Simulation, Training and Robotics Center (E-STAR) is the focal point of all simulation and robotics work at Emory.

Smith, who directs the E-STAR program, and his team are currently developing and applying simulation-based educational tools, devices, curricula and robotics for use in medical education, training and patient care.

“Robotics and simulation technology are altering how surgeons develop skills and treat patients,” Smith said. “Simulation is a complementary alternative to the standard methods used to teach surgical procedures, such as practicing on animal models or cadavers, observing or assisting a senior surgeon, or performing procedures under the supervision of an attending surgeon.

“The use of robotics in the operating room—from the performance of delicate procedures, to surgeons robotically assisting one another remotely via Internet connections—will allow physicians to better transfer knowledge and improve care delivery around the globe.”

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