17 Jun 2002
Surgeons in the US are the first to complete trans-Atlantic telesurgery on a patient in France.
Time delays from long-distance transmissions have until now limited the distances over which surgeons can perform remote telesurgery to a few hundred miles. But thanks to a fiber-optic link that reduces delays to just 150 ms, surgeons operating from New York have removed the gall bladder from a woman in Strasbourg, (Science, 412, 379-380).
A team of 40 people worked across 4000 miles to make the operation a success. They comprised surgeons from the France-based Institute for Research into Cancer of the Digestive System, Computer Motion, a US maker of surgical robotic systems and French telecoms operator France Telecom.
To perform the operation the surgeons used Computer Motion's robotic system, which comprised a surgical console in New York linked to a three-armed robot in Strasbourg. An optical link and endoscopic camera, inserted in the patient's stomach, allowed the surgeons to view their work over a video screen.
France Telecom's fiber-optic network linked each site, but for the surgeons to operate safely on the woman in Strasbourg, transmission delays had to be limited to 330 ms. To achieve this the operator connected its trans-Atlantic network to network termination units (NTUs) based at each site. The NTUs connected all surgical applications via a 10 Mbit/s network.
Network monitoring revealed a round-trip data delay of just 78-80 ms. After adding delays for video coding, and signal adaption and conversion, the time taken for the New York-based surgeon to view his movements was just 155 ms.
Having now completed their first patient operation successfully, the surgeons believe that robot telesurgery will remove the geographical constraints on specialized surgery.
"[The operation] lays the foundations for the globalization of surgical procedures," said Jacques Marescaux, leader of the Strasbourg team of surgeons. "[One] can imagine a surgeon could perform on a patient anywhere in the world."