Taking full advantage of the next-generation of wireless connectivity, researchers in Italy have conducted research showing how a surgeon successfully performed telesurgery from over 9 miles away, operating on a cadaver patient via robotic system.
The research was done by a team of scientists from the Istituto Italiano di Tecnologia in Genoa and published in the journal Annals of Internal Medicine.
It detailed how a new teleoperated surgical robotic system hooked up to a 5G network performed an operation on the vocal cords of an adult human cadaver.
An otorhinolaryngologist located at Vodafone Village, southwest of Milan, was tasked with handling the robotic system. Meanwhile, a cadaver was located at an anatomy lab of San Raffaele hospital, roughly 9 miles northeast of the city.
“This 5G telesurgery experiment showed that the surgeon had effective control of the surgical robot, forceps, and laser and could confidently perform high-precision laser cordectomies on the cadaver’s vocal cords,” the paper explained.
“This was largely because of the high-quality telepresence experience delivered by the robots and interfaces, which allowed the surgeon to manipulate the cadaver’s vocal cords as if he were in the operating room directly operating on a patient.”
The team said the properties of 5G, low latency and high bandwidth, helped to facilitate the research, the same capabilities telecommunication companies say will revolutionize wireless connections on smartphones and internet-of-things (IoT) devices.
Leonardo De Mattos, a lead author of the research, told Newsweek remote telesurgery had been a “dream for many years,” with the study proving to be “exciting verification” it is possible to manage over 5G, which is slowly rolling out across the world.
“The main result of this research is the first proof that telesurgery is feasible using 5G, the new generation of mobile telecommunication networks. This way of performing surgery has been a dream for more than 20 years,” De Mattos said.
He continued: “In 2001, pioneers performed the first demonstration of long-distance telesurgery and large excitement was created around it.
“The reproduction of this early feat proved impossible for many years, given the limited availability of surgical robots and the lack of fast and reliable network connections.”
“Now, the presence of surgical robots in operating rooms is becoming increasingly common, and 5G is quickly becoming a reality worldwide, bringing ultra‐fast, stable and reliable data transmission. With this demonstration, it is now possible to consider a large scale adoption of the technology,” De Mattos said.
The authors noted in the research paper it was quickly “becoming a reality” and described 5G as a “critical enabling technology” for the future viability of telesurgery.
They said the research had proved the feasibility of “field” hospitals, for example to help medical experts work in remote communities or disaster scenarios.
Of course, it could also emerge as a key tool for professionals to help maintain social distancing measures during the COVID-19 pandemic and beyond.
In correspondence with Newsweek today, De Mattos explained his team’s motivations for the medical research and explained how the technology would evolve in the future. The researcher’s responses have been lightly edited for length and clarity.
What motivated you to conduct this research?
“Telesurgery has been a dream for many years given its potential to allow collaborative surgery over very large distances, to transform surgical training, and to make surgical expertise available globally. Now, the current pandemic also highlights the benefits of such technology to ensure the safe distancing between infected patients and the surgeon, contributing to protect the health of critical medical personnel.
“We decided to do this research before the COVID pandemic, but at the onset of 5G. The characteristics of [the tech], such as ultra-low latency and high bandwidth up to 1 Gb/s, suggested it could be an enabling technology for telesurgery. We wanted to test this on a realistic scenario, so that’s why we decided to conduct this research.”
What are the biggest implications for the future of remote surgery?
“The biggest implication is the fact that we now know telesurgery is feasible over 5G. From the technology point of view, both 5G and the remote control of surgical robots have to mature and prove their reliability and safety in such critical applications.
“It is obviously unacceptable to have a system crash in the middle of an operation due to hardware, software or network problems.
“Serious issues regarding the legal and ethical aspects of remote telesurgery have to be studied and resolved, especially when considering international scenarios.”
Did anything surprise you when conducting the research?
“There were no big surprises apart from the exciting verification that the system worked. The biggest unknown regarded the latency perceived by the surgeon when controlling the remote robot. Minimizing latency while maintaining the quality of the information presented to the surgeon (specially the 3D video of the surgical site) required a lot of engineering efforts, both from roboticists and telecommunication engineers.
“But in the end we did it, and the surgeons were quite happy with their experience. Delays were present, and we are still investigating ways to minimize them, but they did not bother the surgeons and did not affect the execution of the surgical actions.”
What’s next for your team, and how will the research evolve?
“The team is working on refining the system to improve its robustness and further minimize latencies during teleoperation.
“We are also working on safety supervision methods and risk mitigation tasks in view of certifying the systems for real clinical use. In addition, we continue to work closely with the surgical team to refine the surgical setup and make it applicable to a wider range of operations. To speed up progress towards a clinical system we would like to collaborate with a surgical robot manufacturer, but that is still under negotiation.”
