Robotic Surgical Systems Development

	Surgeons throughout the world use SRI-developed robotic surgery technology to help patients recover faster, with less pain and fewer complications. (Photos: Intuitive Surgical)

Patient benefits of minimally invasive surgery (MIS)  — faster recovery time, less cosmetic damage, and lower overall costs — have driven demand for MIS procedures. Yet from the surgeon's perspective, performing such procedures can be awkward and require special training. Many years ago, SRI International recognized that by combining the proper technologies it could create a new method of surgery — telepresence surgery — that provides the patient benefits of MIS without the compromises.

By combining advances in stereo imaging, telerobotics, haptics (the technology of touch), video, and telecommunications, SRI’s telepresence system can provide surgeons with the sensory experience of conventional open surgery. Auditory, visual and tactile sensations, including the force or pressure felt while making an incision, are communicated directly to the surgeon performing the operation.

In the 1980s, SRI developed the first telepresence surgery technology under contract to the U.S. Army, with a goal to develop a battlefield-based trauma surgery system that could be operated remotely by a surgeon. Telepresence technology can help medical units deliver care right into a combat zone. Early medical treatment of critically wounded soldiers many dramatically increase their chance for survival.

In the 1990s, further technology improvements were made with funding from the National Institutes of Health.

Commercial Applications

1995: SRI formed Intuitive Surgical, Inc. to commercialize its revolutionary robotic surgical technology.

1999: Intuitive launched the da Vinci Surgical System.

2000: The da Vinci system is cleared by the FDA for general laparoscopic surgery.

2000–Present: The U.S. FDA cleared the da Vinci Surgical System for thoracoscopic (chest) surgery, for cardiac procedures performed with adjunctive incisions, and urologic and gynecologic procedures.

Today, Intuitive Surgical (Nasdaq: INTU) and its da Vinci Surgical Suite is the market leader in robotic surgery, with nearly 300 da Vinci Systems installed in hospitals worldwide. Surgical patients around the globe are benefiting by recovering more quickly, with less pain and fewer complications.

Newest Developments

	The M7 Surgical Robot represents SRI’s latest advances in telepresence surgery technology.

M7 Surgical Robot: Beginning in 1998 under contract to the Telemedicine and Advanced Technology Research Center (TATRC), SRI developed the M7, an advanced version of SRI’s original telepresence system, with these features:

Telepresence Microsurgery: Not only has SRI’s technology permitted teleoperation over great distances, but it has also permitted the scaling of motion and force feedback, enabling microsurgical procedures impossible without robotic assistance. SRI developed and demonstrated this seven degree-of-freedom dual manipulator robotic microsurgical system for suturing lacerations of the cornea. Motions are scaled down by a factor of 10, and tremor was virtually eliminated. SRI is presently integrating laser tissue welding technology with this microsurgical robot, permitting rapid attachment of tissue without using the high forces required with conventional suturing.

Trauma Pod: In 2005, the Defense Advanced Research Projects Agency (DARPA) Defense Sciences Office (DSO) awarded an SRI International-led, multi-organization team a contract to develop a future generation of battlefield-based unmanned medical treatment system, or "trauma pod," to stabilize injured soldiers within minutes after a battlefield trauma, and administer life-saving medical and surgical care prior to evacuation and during transport.

	NEEMO 9 mission. (Photo: CMAS)

Surgery in Extreme Environments: In 2006, in collaboration with NASA, the U.S. Army Medical Research and Materiel Command's Telemedicine and Advanced Technology Research Center (TATRC), and the Canadian Centre for Minimal Access Surgery (CMAS), SRI successfully demonstrated a remote robotic surgical system as part of the ninth NASA Extreme Environment Mission Operations (NEEMO) in the Aquarius Underwater Laboratory, located 60 feet underwater and off the coast of Key Largo, Florida.

For the mission, SRI’s robot electronics were redesigned to permit long-distance operation over IP networks. NEEMO 9 marked the first time an entire robotic surgical system was transported to an extreme environment and manipulated successfully from afar.

The medical procedures simulated may one day be used to respond to emergencies on the International Space Station, the moon, or Mars. The technology is also applicable in remote regions on earth where there is limited medical care.

For more information on SRI’s robotic surgical systems development, contact Pablo Garcia at 650-859-5419 or .