for National Geographic News
The era of "laptop" surgery has begun.
In a medical milestone that will eventually move major surgery beyond the operating room and into areas all around the world, French and U.S. scientists performed a trans-oceanic operation completely by remote control.
The operating surgeons were in New York, the patient in Strasbourg, France. Through a high-quality telecommunications circuit, the doctors in New York guided the movements of a three-armed robot in Strasbourgabout 6,230 kilometers (3,870 miles) awaythat removed the gallbladder of a 68-year-old woman.
One of the robotic arms held a camera probe like those now used in many common medical procedures to examine internal areas of the body and guide surgery on internal organsa technique known as laparoscopy. The other two arms wielded the surgical instruments.
Other surgeons stood by in Strasbourg to make sure the operation went smoothly. The procedure, which was done September 7, took 54 minutes. The patient recovered without complications and went home two days later, according to the medical team.
The researchers announced the successful results at a news conference Wednesday in Paris. A report on the pioneering operation will be published in the September 27 issue of Nature, but the journal posted the information early on its Web site.
Although it will take many years before the technology is commercially available, the researchers say it opens the way to an era of fully interconnected medicine and surgery without borders.
"It's a gallbladder operation today, but in the future it could be any kind of medical procedure," said team member Michael Gagner, chief of the Department of Laparoscopic Surgery at Mount Sinai Medical Center in New York.
Along with Jacques Marescaux of the University of Strasbourg and the IRCAD European Institute of Telesurgery, Gagner was at the console in New York where the surgeons transmitted instructions to the robot.
"As the technology evolves and becomes available, and wiring is more widespread, it will be useful for telementoring, teaching, and performing rare surgery that requires different expertise," Gagner added. "A smaller city could have the help of an expert surgeon just by being connected."
As the technology becomes portable, it should also be possible to perform complex surgery even at remote disaster sites and battlefields, when response time is critical, and in developing countries that have few or no surgeons, the researchers say.
"The idea of telecollaborative surgery is hugely important because of the tremendous positive societal impact," said Yulun Wang, the founder and chief technical officer of Computer Motion Inc. in Goleta, California.
Computer Motion developed the robotic systemcalled ZEUSthat was used in the trans-Atlantic operation. FranceTelecom/Equant was also a partner in the project, responsible for ensuring the transfer of information via a high-speed optical-fiber network.
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