Future of Healthcare Robotics
Richard M. Satava, MD FACS
Professor of Surgery
University of Washington
Program Manager, Advanced Biomedical Technologies
Defense Advanced Research Projects Agency (DARPA)
and
Special Assistant, Advance Medical Technologies
US Army Medical Research and Materiel Command
CyberTherapy 2005
Robotics Session
Basel, Switzerland
June 7, 2005

Prediction
“Prediction is difficult . . .
. . . especially about the Future”
….Yogi Berra

Virtual Reality … the promise of the future
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Virtual Reality … the realization of the future
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Surgeon of the Future ?? Cybertherapist of the Future ??

Wizard of Id
by Brant Parker

Superhuman Robots!
Movie: Alien The Touch Lab, MIT

Current Visions
“The Future is here …
. . . it’s the Information Age”

Holomer
Total body-scan for total diagnosis
From visible human to Virtual Soldier
Multi-modal total body scan on every trauma patient in 15 seconds
Satava March, 2004

Why robotics, imaging and
modeling & simulation
• Healthcare is the only industry without a
computer representation of its “product”
•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 . . .
thus
• An operating room is an information system with . . .

Total Integration of Surgical Care
Minimally Invasive
Surgery
Remote Surgery
Pre-operative planning Simulation & Training
Joel Jensen,
Intra-operative navigation SRI International, Menlo Park, CA

Remote telesurgery
“Operation Lindberg” ROUTINE telesurgery from
Hamilton to North Bay
First remote and trans-Atlantic
300 mile distant
Telesurgery procedure
Prof. Jacques Marescaux, IRCAD Dr. Mehran Anvari, MD
McMaster Univ, Toronto CANADA

“Penelope” – robotic scrub nurse
Michael Treat MD, Columbia Univ, NYC. 2003

Entirely computerized ICU
Total Patient Awareness
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
Courtesy of Integreated Medical Systems, Signal Hill, CA Power and Oxygen

LSTAT Deployment to Kosovo - March 2000
212th MASH Deployed with LSTAT - Combat Support Hospital
Courtesy of Integreated Medical Systems, Signal Hill, CA

Why now?
VTOL UAV technology is maturing rapidly enough to minimize risk.

Nightingale UAV Goal
Or:
Identify
“optimum” VTOL
UAV design
Create a new
VTOL UAV
tailored to the
operational need
LSTAT

Robotic Medical Assistant
Nursing shortage crisis
Applicable at all levels
Hospitals
Clinics
Nursing Home
Assisted living
SATAVA 7 July, 1999
DARPA
Courtesy Yulun Wang, InTouch Technologies, Inc, Goleta, CA

Honda Humanoid Robot Asimo Honda Motor Company, Tokyo Japan

“Blue Dragon” passive recording device
Courtesy Blake Hannaford, University of Washington, Seattle

Novice
Objective Assessment
Intermediate
Expert
Hand motion tracking patterns Ara Darzi, MD. Imperial College, London, 2000

Integrating Surgical Systems for Autonomy
The Operating Room (personnel) of the Future
100,000
Surgeon Assistant Scrub Nurse Circulating nurse
Satava March, 2000

The Operating Room of the Future

Predator 2003
Fighter Pilots – until 2002 Fighter Pilots – Beyond 2003
SATAVA 7 July, 1999
DARPA

Disruptive Visions
“The Future is not what it used to be”
….Yogi Berra

DARPA Controlled Biological Systems Program
Animats Machine Living Animals
Biomimetic Systems Biohybrid Organisms Biological Systems
•Integration of biological design •New interfaces for measuring •Pheremone control of
for sensorimotor function neural-muscular outputs sensorimotor sensorimotor output - plume
•neural control architecture control in freely moving/sensing tracing
•biomechanical self- behaving biological systems
stabilization •Plasticity of associative
•sensor/performance •Stimulation of neural and muscular learning to threats of interest
systems to influence sensorimotor (conditioned training)
•Autonomous navigation function
•Investigate behavior with
•Modular design/fabrication of •Inexpensive attachment of sensors sensor motor architecture
fault tolerant mobile sensor (chem/bio)
platforms
Courtesy Alan Rudolph, Program Manager, 1999

Biomimetic robot - Ariel

Biomimetic Micro-robot
Courtesy Sandia National Labs

Capsule camera for gastrointestinal endoscopy
Courtesy Paul Swain, London, England

Femtosecond Laser
(1 x 10 –15 sec)
Los Alamos National Labs, Los Alamos NM
Time of Flight Spectroscopy
Cold Spring Harbor Laboratory, Long Island, NY Cellular opto-poration

BioSurgery
Satava September 2003

tial
fi d en
C on

Technologies will change the Future
• The rate of new discovery is accelerating exponentially
• The changes raise profound fundamental issues
• Moral and ethical solutions will take decades to resolve
Sector
Technology
Rate of Change
Business
Society
Healthcare
TIME
Differing responses to scientific discovery by various sectors

And just what are these profound moral and ethical issues?

Gaak Kismet
Intelligent “Living Robot”
Uses genetic algorithms to “learn”
TECHNOLOGY NEWS
\"Thinking\" robot in escape bid
Scientists running a pioneering experiment with
robots which think for themselves have caught one Courtesy Rosalind Picard,
trying to flee the centre where it \"lives\". MIT Affective Computing Lab, Boston, MA
The small unit, called Gaak, is one of 12 taking
part in a \"survival of the fittest\" test at the Magna
science centre in Rotherham, South Yorkshire,
which has been running since March.
E D
Gaak made its bid for freedom after it had been
taken out of the arena where hundreds of visitors
AP
watch the machines learning how to repair
themselves after doing daily battle.
S C
Professor Noel Sharkey said he turned his back
on the drone, but when he returned 15 minutes
later he found it had forced its way out of the
E
small make-shift paddock it was being kept in.
He later found it had travelled down an access
slope, through the front door of the centre and was
discovered at the main entrance to the car park
when a visitor nearly flattened it with his car.
Courtesy Professor Noel Sharkey, Sheffield Unversity, London

WHEN COMPUTERS EXCEED
Humans vs Machine HUMAN INTELLIGENCE
Humans 4.0X10 19 cps
Red Storm 3.5X10 15 cps The Age of
Moore’ s Law Spiritual
“computer power doubles
Machines
ROBOT
every 18 months”
Do the Math !!
Ray Kurzweil
Who is smarter now??
Hans Moravec
Will Machines become “smarter than humans?

Do Robots Dream ?