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Submerging Surgery

Photo: NOAA/University of North Carolina Wilmington

BOT on board: In an underwater lab in Florida, a surgical robot controlled from Canada stitches up a vein on a latex model.

A few months ago, our colleague Timothy Broderick, a professor of surgery and biomedical engineering at the University of Cincinnati, chose an unusual place for an experiment in surgical robotics. As part of the NASA Extreme Environment Mission Operations, or NEEMO, project, he headed out to the Aquarius habitat, located 19 meters underwater off Key Largo, Florida, and in that cramped laboratory he set up an experimental two-armed surgical robot [photo].

Broderick requested the help of another surgeon, Mehran Anvari of McMaster University, in Hamilton, Ont., Canada, who controlled the robot from his office 2000 kilometers to the north. Despite a delay of up to 2 seconds, Anvari was able to successfully simulate complex surgical tasks, such as suturing a vein, on a latex anatomical model.

The surgical robot used by Broderick and Anvari was a modified version of a system originally developed in the early 1990s by Phil Green, a researcher at SRI International, for the U.S. military. The highly influential SRI project encouraged the start-up of two companies to address the civilian robotic surgery market: Computer Motion, in Goleta, Calif., and Intuitive Surgical, in Sunnyvale, Calif.

In 2001, Jacques Marescaux, a surgeon at the University of Strasbourg, in France, worked with Computer Motion to modify its system and perform the first remote surgery on a human patient, a gallbladder removal procedure called laparoscopic cholecystectomy. Using a dedicated high-speed connection, Marescaux controlled the robot from New York City while the patient lay in an operating room in Strasbourg.

In 2003, a lengthy patent litigation ended with the merger of Computer Motion and Intuitive Surgical. Under the name of Intuitive Surgical, the merged company is now the only one to commercialize a robotic surgical system approved by the U.S. Food and Drug Administration. The FDA-approved procedures include general laparoscopic surgery, chest ­surgery, certain cardiac procedures, and urological and gynecological procedures. —J.R. & B.H.