Lindbergh operation

Last updated

The Lindbergh operation was a complete tele-surgical operation carried out by a team of French surgeons located in New York on a patient in Strasbourg, France (over a distance of several thousand miles) using telecommunications solutions based on high-speed services and sophisticated Zeus surgical robot. The operation was performed successfully on September 7, 2001, by Professor Jacques Marescaux and his team from the IRCAD (Institute for Research into Cancer of the Digestive System). This was the first time in medical history that a technical solution proved capable of reducing the time delay inherent to long distance transmissions sufficiently to make this type of procedure possible. The name was derived from the American aviator Charles Lindbergh, because he was the first person to fly solo across the Atlantic Ocean.

Contents

Details of the procedure

The operation involved minimally invasive surgery: The 45-minute procedure consisted of a cholecystectomy on a 68-year-old female patient in surgical ward A in Strasbourg Civil Hospital, in Eastern France. From New York, the surgeon controlled the arms of the ZEUS Robotic Surgical System, designed by Computer Motion, to operate on the patient. The link between the robotic system and the surgeon was provided by a high-speed fiberoptic service deployed thanks to the combined efforts of several France Telecom group entities.

Commenting on the operation, Professor Marescaux said:

I believe that this demonstration of the feasibility of a completely safe remotely performed surgical procedure—and notably the first trans-Atlantic operation—ushers in the third revolution we've seen in the field of surgery in the past ten years.

The first was the arrival of minimally invasive surgery, enabling procedures to be performed with guidance by a camera, meaning that the abdomen and thorax do not have to be opened. The second was the introduction of computer-assisted surgery, where artificial intelligence enhances the safety of the surgeon's movements during a procedure, rendering them more accurate, while introducing the concept of distance between the surgeon and the patient. It was thus a natural extrapolation to imagine that this distance—currently several meters in the operating room—could potentially be up to several thousand kilometers.
This is what we have just demonstrated thanks to the combined technical prowess of Computer Motion, which created the digital robot required, and France Telecom, which was able to deploy a broadband transmission service with optimized compression, thus limiting the time delay between the command of the action and its return on the monitor to a level that is virtually imperceptible to the human eye.

The demonstration of the feasibility of a trans-Atlantic procedure—dubbed 'Operation Lindbergh' is a richly symbolic milestone. It lays the foundations for the globalization of surgical procedures, making it possible to imagine that a surgeon could perform an operation on a patient anywhere in the world.

Project partners

The surgery was the result of a closely coordinated partnership between IRCAD, the France Télécom group and Computer Motion, the developer of Zeus surgical robotic systems. The EITS (European Institute of Telesurgery) was also involved.

Computer Motion - Zeus Telesurgery System

The Zeus robotic system was developed in mid 1990s to enable a surgeon in the OR to perform the operation seated at surgeon console a few meters away vs. traditional surgery where surgeon was at the OR table and next to the patient. The telesurgery project named Lindbergh operation required the Zeus robotic system to be modified so the surgeon is thousands of miles away from the OR table. There were many challenges to overcome: Zeus system was an FDA cleared surgical system and none of its software could be adjusted due to the clearance, and also in part because of lack of assigned engineering resources to the project as main focus of the company was on next generation Zeus projects including redesign of the surgeon console from "instrument handle control" to "instrument tip control". This project was internally assigned in late 1999 to one of Computer Motion's seasoned engineers, Moji Ghodoussi, Ph.D. to manage, with engineering lead assigned to Sudipto Sur, Ph.D. Significant challenges: technical, operational, business, personnel, regulatory, and more were met along the way, which at a later date will be published either here or under a separate page that will shed light for future teams innovating in fields of technology in general and surgery in particular.

See also

Related Research Articles

General surgery Medical specialty

General surgery is a surgical specialty that focuses on alimentary canal and abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, appendix and bile ducts, and often the thyroid gland. They also deal with diseases involving the skin, breast, soft tissue, trauma, peripheral artery disease and hernias and perform endoscopic procedures such as gastroscopy and colonoscopy.

Neurosurgery Medical specialty of disorders which affect any portion of the nervous system

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.

Laparoscopy Minimally invasive operations within the abdominal or pelvic cavities

Laparoscopy is an operation performed in the abdomen or pelvis using small incisions with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.

Remote surgery is the ability for a doctor to perform surgery on a patient even though they are not physically in the same location. It is a form of telepresence. A robot surgical system generally consists of one or more arms, a master controller (console), and a sensory system giving feedback to the user. Remote surgery combines elements of robotics, telecommunications such as high-speed data connections and elements of management information systems. While the field of robotic surgery is fairly well established, most of these robots are controlled by surgeons at the location of the surgery. Remote surgery is remote work for surgeons, where the physical distance between the surgeon and the patient is less relevant. It promises to allow the expertise of specialized surgeons to be available to patients worldwide, without the need for patients to travel beyond their local hospital.

Cardiac surgery Type of surgery performed on the heart

Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease ; to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation.

Image-guided surgery (IGS) is any surgical procedure where the surgeon uses tracked surgical instruments in conjunction with preoperative or intraoperative images in order to directly or indirectly guide the procedure. Image guided surgery systems use cameras, ultrasonic, electromagnetic or a combination or fields to capture and relay the patient's anatomy and the surgeon's precise movements in relation to the patient, to computer monitors in the operating room or to augmented reality headsets. This is generally performed in real-time though there may be delays of seconds or minutes depending on the modality and application.

Prostatectomy Surgical removal of all or part of the prostate gland

Prostatectomy as a medical term refers to the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.

Robot-assisted surgery Surgical procedure

Robotic surgery are types of surgical procedures that are done using robotic systems. Robotically assisted surgery was developed to try to overcome the limitations of pre-existing minimally-invasive surgical procedures and to enhance the capabilities of surgeons performing open surgery.

Computer-assisted orthopedic surgery

Computer-assisted orthopedic surgery or computer-assisted orthopaedic surgery is a discipline where computer technology is applied pre-, intra- and/or post-operatively to improve the outcome of orthopedic surgical procedures. Although records show that it has been implemented since the 1990s, CAOS is still an active research discipline which brings together orthopedic practitioners with traditionally technical disciplines, such as engineering, computer science and robotics.

Intuitive Surgical American Biotechnology Company

Intuitive Surgical, Inc. is an American corporation that develops, manufactures, and markets robotic products designed to improve clinical outcomes of patients through minimally invasive surgery, most notably with the da Vinci Surgical System. The company is part of the NASDAQ-100 and S&P 500. As of 31 December 2021, Intuitive Surgical had an installed base of 6,730 da Vinci Surgical Systems, including 4,139 in the U.S., 1,199 in Europe, 1,050 in Asia, and 342 in the rest of the world.

Tubal reversal, also called tubal sterilization reversal, tubal ligation reversal, or microsurgical tubal reanastomosis, is a surgical procedure that can restore fertility to women after a tubal ligation. By rejoining the separated segments of the fallopian tube, tubal reversal can give women the chance to become pregnant again. In some cases, however, the separated segments cannot actually be reattached to each other. In some cases the remaining segment of tube needs to be re-implanted into the uterus. In other cases, when the end of the tube has been removed, a procedure called a neofimbrioplasty must be performed to recreate a functional end of the tube which can then act like the missing fimbria and retrieve the egg that has been released during ovulation.

NeuroArm is an engineering research surgical robot specifically designed for neurosurgery. It is the first image-guided, MR-compatible surgical robot that has the capability to perform both microsurgery and stereotaxy.

Bone segment navigation is a surgical method used to find the anatomical position of displaced bone fragments in fractures, or to position surgically created fragments in craniofacial surgery. Such fragments are later fixed in position by osteosynthesis. It has been developed for use in craniofacial and oral and maxillofacial surgery.

Computer-assisted surgery (CAS) represents a surgical concept and set of methods, that use computer technology for surgical planning, and for guiding or performing surgical interventions. CAS is also known as computer-aided surgery, computer-assisted intervention, image-guided surgery, digital surgery and surgical navigation, but these are terms that are more or less synonymous with CAS. CAS has been a leading factor in the development of robotic surgery.

da Vinci Surgical System Robotic surgical system

The Da Vinci Surgical System is a robotic surgical system that uses a minimally invasive surgical approach. The system is manufactured by the company Intuitive Surgical. The system is used for prostatectomies, and increasingly for cardiac valve repair, and for renal and gynecologic surgical procedures. It was used in an estimated 200,000 surgeries in 2012, most commonly for hysterectomies and prostate removals. The system is called "Da Vinci" in part because Leonardo da Vinci's study of human anatomy eventually led to the design of the first known robot in history.

The ZEUS Robotic Surgical System (ZRSS) was a medical robot designed to assist in surgery, originally produced by the American robotics company Computer Motion. Its predecessor, AESOP, was cleared by the Food and Drug Administration in 1994 to assist surgeons in minimally invasive surgery. The ZRSS itself was cleared by the FDA seven years later, in 2001. ZEUS had three robotic arms, which were remotely controlled by the surgeon. The first arm, AESOP, was a voice-activated endoscope, allowing the surgeon to see inside the patient's body. The other two robotic arms mimicked the surgeon's movements to make precise incisions and extractions. ZEUS was discontinued in 2003, following the merger of Computer Motion with its rival Intuitive Surgical; the merged company instead developed the Da Vinci Surgical System.

Timothy J. Broderick Professor of Surgery and Biomedical Engineering at the University of Cincinnati

Timothy J. Broderick, F.A.C.S., is Professor of Surgery and Biomedical Engineering at the University of Cincinnati, where he has served on the faculty since 2003. He also serves as Chief of the Division of Gastrointestinal and Endocrine Surgery and is Director of the Advanced Center for Telemedicine and Surgical Innovation (ACTSI). He has flown on the NASA KC-135 parabolic laboratory and dived in the NASA Extreme Environment Mission Operations (NEEMO) program to develop advanced surgical technologies for long duration space flight.

MiroSurge is a presently prototypic robotic system designed mainly for research in minimally invasive telesurgery. In the described configuration, the system is designed according to the master slave principle and enables the operator to remotely control minimally invasive surgical instruments including force/torque feedback. The scenario is developed at the Institute of Robotics and Mechatronics within the German Aerospace Center (DLR).

Computer-assisted interventions (CAI) is a field of research and practice, where medical interventions are supported by computer-based tools and methodologies. Examples include:

AdventHealth Nicholson Center

The AdventHealth Nicholson Center is a medical research and training center with locations in Celebration and Orlando, Florida. Founded in 2001, it operates within the AdventHealth network and trains physicians on foundational surgical techniques, including robotic surgery and laparoscopic surgery, using tools like robotic simulators, wet and dry labs. Using emerging robotic, laparoscopic and orthopedic surgical techniques, the Nicholson Center is researching to develop modified ways to operate.

References

    This page is based on this Wikipedia article
    Text is available under the CC BY-SA 4.0 license; additional terms may apply.
    Images, videos and audio are available under their respective licenses.