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A team of four astronauts are to splashdown to an undersea laboratory in the US on Monday, to help conduct the first wireless robot-assisted surgery. Meanwhile in Canada - 2000 kilometers away from the operating table - a surgeon prepares to perform the procedures, to be carried out on Tuesday.
This will be the first time that surgical procedures, performed from a vast distance away, will utilize airwaves rather than undersea cables to transmit the information, says surgeon Tim Broderick of the University of Cincinnati, Ohio, who will be taking part in the NASA experiment, dubbed NEEMO 7.
Although the procedures, which include a gall bladder removal, will actually be carried out on a surgical training dummy, the NASA experiment is being seen as a crucial proof-of-principle. If the surgery is successful, it is hoped that astronauts will eventually be allowed to receive emergency surgical care while aboard the International Space Station (ISS).
Under the sea
Surgeon Mehran Anvari of the Centre for Minimal Access Surgery at St Josephs Hospital in Hamilton, Ontario, will be using the Zeus robotic surgical system to control the robot in the Aquarius lab, 19 meters under the sea, in Key Largo, Florida. Zeus has two robotic arms and an endoscopic arm, which can be controlled by the surgeon from a console of monitors and joysticks.
But a bigger issue is latency, or signal delay. If the signal is delayed by more than 0.7 seconds, a surgeon will begin to have problems controlling the robot. This should not affect operations on the ISS, but for deeper space missions - such as one to Mars - more autonomous robots would have to be used.
The chance of losing the signal is extremely slim, says Broderick, because of the redundancy built into the radio link up. But if the robots link was lost the procedure would have to be finished by telementoring the astronauts on standby, which is another situation this experiment was set up to explore.
The underwater astronauts will try to carry out several procedures for themselves - such as ultrasonic diagnostics and kidney stone extraction - under the guidance of surgeons on the surface. We need to understand what level of medical background a person needs to be able to carry out medical procedures, says Williams.
The Aquarius is a very good analogue for the space station, says Broderick. Just as in space, he says, it can take time to get a patient back to solid ground when they need emergency surgery underwater. They have to decompress for a day before they can come up, he says.
The dilemma is whether the ISS should be equipped with a telerobot rather than having to bring an astronaut down to Earth when they need surgery. Flying an astronaut down is a half-billion dollar decision, says astronaut Dave Williams, who was due to lead this experiment but had to pull out for medical reasons. Williams says he has utmost confidence in the wireless link and would not have a problem being operated on over the airwaves.
The "tornado" is generated by a patented device from Vortex HC, LLC of Morrisville, N.C., said Janet, who is vice president of development at the company. The device uses air currents swirling in a cylinder, about the size of an upside-down tuna can, to exert suction on a wall or ceiling. An impeller in the cylinder spins like a propeller but recirculates captive air rather than sucking air in one end and blasting it out the other. "It’s a tornado in a cup, but no ordinary tornado," Janet said. "Two vortexes swirl simultaneously, one in a spiral and the other in a toroidal path, like a donut. The forces generated hold the vehicle to the wall and yet allow free movement because the cup never touches the surface."
Parker said the Madrid competition required performing five tasks: starting on the metal competition wall and climbing as high as possible; climbing after the addition of randomly placed obstacles; crossing a barrier placed on the wall; starting from the floor and then climbing; and stopping after crossing the finish line. "We faced stiff competition from German and Italian teams," Parker said. "The robot from the University of Catania was amazingly good at detecting and avoiding all the obstacles. Our robot brushed against a couple of obstacles, but it was the only one that completed all five tasks."
Janet said the Duke team combined the "tornado in a cup" technology with an original control system. "A human operates Vortex’s commercial robots by remote control," Janet said. "The students added sensors and wrote software that enables their robot to operate on its own." Parker said they added ultrasonic and infrared sensors across the front and programmed a tiny computer, called a microcontroller, to navigate based on information from the sensors. Ultrasonic sensors detect objects by bouncing sonar-like sound waves off them. Infrared sensors, used in television remote controls, detect light outside the range of human vision.
The Duke wall-climbing robot was funded by a grant from the Lord Foundation. Janet said the Vortex technology was developed by Vortex HC on a grant from the DARPA Microsystems Technology Office.
Burney provided an initial basic design for the Duke vehicle, Janet said. Meyerson and Parker, both biomedical engineering students, focused on writing software and incorporating the sensors. When tests showed the centimeter-high barrier broke the hold of the Vortex technology, Janet called in Finlay to solve the problem of crossing the barrier without falling off the wall. Finlay is a mechanical engineering student and a veteran of the team that produced Duke’s prize-winning autonomous underwater vehicle Charybdis.
Finlay said he tried to design a solution that would work with or without the metal wall at the competition. "We tried adding treads," Finlay said. "We tried a wheelie bar to keep the rear end of the robot flat against the wall and prevent the front from lifting up. Unfortunately, the results were disappointing. Time was running out so we had to add magnets and take advantage of the metal."
According to Finlay, the magnets were successfully tested only one day before the team flew to Spain. In Madrid, Meyerson and Parker had to adapt the robot’s software for the competition wall. "The traction was different from what we were used to," Meyerson said.
With software tuned and magnets added, Walter crossed the centimeter barrier without difficulty in practice runs. However, in the first competition runs, Walter slipped down the wall when attempting to cross."
There were 15 minutes of pure terror and panic," Parker said. "We didn’t know what was wrong." Burney said, "We finally realized we had the brackets for the magnets on wrong. The magnets were upside down, and the magnetism was too weak that way."With the magnets positioned correctly, Walter negotiated the barrier, reached the top of the wall, and won the first prize of about $250.
The team left Madrid triumphant but exhausted from coping with the competition while keeping Spanish hours without the siestas, said Meyerson. "Restaurants don't open for dinner until nine and a meal takes hours," Meyerson said. "Everyone stays out until four a.m. and that’s without even trying to go clubbing."
Janet said Duke’s future robotics efforts include teaming with a group from Carnegie Mellon University for the DARPA (Defense Advanced Research Projects Agency) Grand Challenge to design a full-sized autonomous land vehicle and continuing the development of autonomous underwater vehicles.
In addition, computer science professor Ronald Parr and graduate student Austin Eliazar are developing software that enables a mobile robot to map its surroundings as it moves and simultaneously locate itself on the map. Such "simultaneous localization and mapping" is a longstanding challenge in robotics research.