Remote surgery

Abstract: Remote robot-assisted telesurgery is feasible and safe using terrestrial telecommunication lines, even through transcontinental distances. In addition to several potential benefits for the patient, remote surgery might improve surgical training and education. Future developments of computer technology and their surgical applications, particularly in the field of virtual reality three-dimensional reconstructions of patient’s specific anatomy and pathology, are the possible solutions to overcome the lack of direct patient-surgeon contact. Indeed, virtual reality systems may not only improve surgical performance by allowing preoperative simulations and rehearsal of surgical procedures ahead of time, but may also allow, thanks to real-time Internet teleconsultations, active intervention of the operating surgeon in the diagnostic process and in the evaluation of indications and contraindications to surgery.

Abstract: The concept of digital twin (DT) has emerged to enable the benefits of future paradigms such as the industrial Internet of Things and Industry 4.0. The idea is to bring every data source and control interface description related to a product or process available through a single interface, for auto-discovery and automated communication establishment. However, designing the architecture of a DT to serve every future application is an ambitious task. Therefore, the prototyping systems for specific applications are required to design the DT incrementally. We developed a novel DT prototype to analyze the requirements of communication in a mission-critical application such as mobile networks supported remote surgery. Such operations require low latency and high levels of security and reliability and therefore are a perfect subject for analyzing DT communication and cybersecurity. The system comprised of a robotic arm and HTC vive virtual reality (VR) system connected over a 4G mobile network. More than 70 test users were employed to assess the system. To address the cybersecurity of the system, we incorporated a network manipulation module to test the effect of network outages and attacks; we studied state of the art practices and their utilization within DTs. The capability of the system for actual remote surgery is limited by capabilities of the VR system and insufficient feedback from the robot. However, simulations and research of remote surgeries could be conducted with the system. As a result, we propose ideas for communication establishment and necessary cybersecurity technologies that will help in developing the DT architecture. Furthermore, we concluded that developing the DT requires cross-disciplinary development in several different engineering fields. Each field makes use of its own tools and methods, which do not always fit together perfectly. This is a potentially major obstacle in the realization of Industry 4.0 and similar concepts.

Abstract: A remote surgery supporting system and a method thereof produces a presentation of realism control data generated by realism control data generating means 101 from image data obtained from work environment data detecting means 104 and measurement data processing means 118 and from force and proximity data. While viewing this presentation, the surgical operator inputs actions through action command inputting means 114 and thereafter, diseased tissue manipulating means 102 executes a procedure on diseased part 125. The manipulation force of each surgical operator received from manipulation command generating means 103 and force reflection from the diseased part 125 are combined and presented to the action command inputting means 114. Thereby, a plurality of surgical operators can perform a surgerical operation while viewing the realism control data and sensing the manipulation force of other surgical operators and the force reflection from the diseased part. Thus, a master/slave type remote surgery supporting system which allows a plurality of surgical operators to perform a surgical operation which requires many degrees of freedom can be provided.

Abstract: Safe and effective implementation of remote surgery and telementoring can have significant limitations. Fifth-generation (5G) wireless networks could be useful in overcoming these drawbacks. As a proof of concept, the authors present technical and clinical details of two procedures assisted by telementoring using 5G that were also broadcast live. Secure remote access advice.