Doarn, C. R., Anvari, M., Low, T., & Broderick, T. J. (2009). Evaluation of teleoperated surgical robots in an enclosed undersea environment. Telemedicine and e-Health, 15(4), 325-335.
Surgical telemanipulation systems, often called surgical robots, were evaluated in an extreme environment. Over three NASA Extreme Environment Mission Operations (NEEMO) missions, researchers evaluated different surgical robotic systems, AESOP, the SRI M7, and the University of Washington BioRobotic Laboratory’s RAVEN. These evaluations were conducted in the National Oceanographic and Atmospheric Administration’s (NOAA) underwater Aquarius habitat. During each of these three missions, the robotic systems, located in the habitat, were controlled from a distant site by a surgeon. This evaluation demonstrated the world’s first semi-autonomous, supervisory-controlled medical task.
The ability to support surgical care in an extreme environment is a significant issue for both military medicine and space medicine. Telemanipulation systems, those that can be remotely operated from a distant site, have been used extensively by the National Aeronautics and Space Administration (NASA) for a number of years. These systems, often called telerobots, have successfully been applied to surgical interventions. A further extension is to operate these robotic systems over data communication networks where robotic slave and master are separated by a great distance. NASA utilizes the National Oceanographic and Atmospheric Administration (NOAA) Aquarius underwater habitat as an analog environment for research and technology evaluation missions, known as NASA Extreme Environment Mission Operations (NEEMO). Three NEEMO missions have provided an opportunity to evaluate teleoperated surgical robotics by astronauts and surgeons. Three robotic systems were deployed to the habitat for evaluation during NEEMO 7, 9, and 12. These systems were linked via a telecommunications link to various sites for remote manipulation. Researchers in the habitat conducted a variety of tests to evaluate performance and applicability in extreme environments. Over three different NEEMO missions, components of the Automated Endoscopic System for Optimal Positioning (AESOP), the M7 Surgical System, and the RAVEN were deployed and evaluated. A number of factors were evaluated, including communication latency and semiautonomous functions. The M7 was modified to permit a remote surgeon the ability to insert a needle into simulated tissue with ultrasound guidance, resulting in the world’s first semi-autonomous supervisory-controlled medical task. The deployment and operation of teleoperated surgical systems and semi-autonomous, supervisory-controlled tasks were successfully conducted.