The Operating Room of the Future Richard M. Satava, MD FACS Professor of Surgery University of Washington School of Medicine and Program Manager, Advanced Biomedical.
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The Operating Room of the Future Richard M. Satava, MD FACS Professor of Surgery University of Washington School of Medicine and Program Manager, Advanced Biomedical Technologies Defense Advanced Research Projects Agency (DARPA) and Special Assistant, Advance Medical Technologies US Army Medical Research and Materiel Command Medicine Meets Virtual Reality MMVR - 12 Newport Beach, CA January 15, 2004 September , 2003 Operating Room of the Future An Operating Room without people September , 2003 Problem Operating room is not integrated and uses industrial age tools which do not meet the needs of advanced technologies The OR size is huge, personnel are many, management is fractured, tempo slow, supply & inventory requirements redundant and realtime quality assurance non-existant. September , 2003 Result An operating room which is dirty maladapted, slow, inefficient, kluged without quality improvement and not cost effective. September , 2003 Current Technology What technology is available today off the shelf that we can adapt to the OR of the Future? September , 2003 The LSTAT • Defibrillator • Ventilator • Suction • Monitoring • Blood Chemistry Analysis • 3-Channel Fluid/Drug Infusion •Data Storage and Transmission • On-board Battery • On-board Oxygen • Accepts Off-Board Power and Oxygen September , 2003 Courtesy of Integrated Medical Systems, Signal Hill, CA LSTAT Deployment – Air, Land and Sea LSTAT Deployed at Operation Brightstar LSTAT Deployed on Naval ship Tarawa - 2002 September , 2003 Courtesy of Integrated Medical Systems, Signal Hill, CA LSTAT Deployment to Kosovo 212th MASH Deployed with LSTAT - Combat Support Hospital September , 2003 Courtesy of Integrated Medical Systems, Signal Hill, CA LSTAT in Battlefield Configuration September , 2003 Courtesy Matt Hanson, Integrated Medical Systems, Signal Hill, CA Next Generation LSTAT – Civilian version Courtesy Integrated Medial Systems, Signal Hill, CA September , 2003 We can adapt from industry… • Clean room technology and standards (today’s OR cannot even meet Class 10,000 standards) • Implement “robotic cell” methods (integrate collaborative robots - below) • Replace humans interacting with robots (scrub, etc) (tool changer for scrub, parts dispenser for circulator) • Miniaturize for mobility and efficiency (tool changer for scrub, parts dispenser for circulator) • Just-in-time billing, supply and inventory (do in millisecs with +100% efficiency what takes hours today) September , 2003 We can adapt from industry… • Pre-operative planning and surgical rehearsal (rehearse [edit] individual patient for “perfect” procedure) • Provide continuous monitoring for performance improve (record/store hand/robot motions to analyze surgical procedure) • Integrated training through patient-specific simulation (embedded training – “train as you fight, fight as you train”) • Record procedure for privileges and credentials (eliminate cramming for periodic examinations) • Become autonomous, single soldier (SurgiPod) (remove surgeons and medics from the battlefield) September , 2003 Why robotics and imaging • A robot is not a machine . . . it is an information system with arms . . . • A CT scanner is not an imaging system it is an information system with eyes . . . . . . etc • An operating room is an information system with . . . September , 2003 A scenario • Preop holding with smart table and anesthesia (suspended animation) •Total body scan on smart table •Pre-operative “asepsis” (not part of this phase - ? SLIME) •Entry-docking of table to robot •Surgeon plans/rehearses Procedure while waiting for patient September , 2003 A scenario (continued) • Edit procedure and operate in minutes (Surgical prototyping) • Robot cell with tool changer and supply dispenser • Automatic billing, re-ordering • Continuously monitor assess (error reduction, proficiency credentials,etc) • Miniature, self-contained, autonomous (mobile, robotic systems on battlefield of FCS) September , 2003 The Challenge Make smart table CT compatible “Sterlization” procedure Integrate robotic “cell” Realtime data acquisition of tools/supplies Integrate pre-op simulation, rehearsal, editing and exporting September , 2003