Page 52 - EETimes Europe June 2021

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The Tech-Enabled Future of Surgery

REMOTE CONSULTATIONS IN HD
Remote consultation will reduce the number of in-
person consultations and the attendant risk of disease
transmission. It will also enable doctors to consult with
other physicians, increasing the pool of knowledge and
experience. Moreover, 5G’s arrival will help improve
video-streaming clarity and definition to enhance the
quality of the consultation.
Artificial intelligence is an essential component of
effective remote consultations. AI has already been
applied to analyze medical images, genetic data, and
patient data to diagnose or predict diseases.
In April, the U.S. FDA authorized the first medical
device using AI to help detect colon cancer. In 2020,
the EU invested in AI to accelerate Covid-19 care,
while the U.S. National Institutes of Health (NIH)
started to harness AI for Covid-19 diagnosis, treat-
ment, and monitoring.
In other efforts, a team at the University of Oxford
has developed a rapid AI-driven Covid-19 triage
method, Siemens is collaborating with partners to
develop Covid-19 diagnostic tests, and Vocalis has
obtained European approval for an AI-based voiceprint
screener that analyzes the words spoken by patients The Mako SmartRobotics system from Stryker utilizes 3D CT-based planning
to identify individuals with Covid-19. Given unlimited technology for hip- and knee-replacement surgeries. (Source: Stryker)
time, human pathologists make more accurate diag-
noses than AI algorithms, but a scenario with no time
constraints is not realistic. Thus, a hybrid model has been proposed in through a tiny opening and within a small space. Microsurgeries of
which the AI system would assist doctors in making effective diag- complex aneurysms, tiny blood vessels, nerves, and eye, ear, and vocal
noses. In the future, such human-machine partnerships may produce cord structures are applicable for biopsies, tumor eradication, and
optimal results. targeted drug delivery. Let us put it in perspective. An inch is 25,400
microns, and a human hair is about 70 microns. A human red blood
REMOTE SURGERY OVER 5G cell is about 8 microns wide — one three-thousandths of an inch — and
Remote surgery can make advanced procedures more accessible for most of the capillary vessels are only as wide as a red blood cell. There-
patients who are too sick to travel. And during an infectious-disease fore, surgeons have to operate with an even smaller field of vision and
epidemic, remote surgery can help contain the spread of infection by space during microsurgery.
minimizing the need for patient transport. Complex surgeries require a miniaturized, multi-backbone robotic
During remote operations, robotic arms and imaging equipment at system with micro-scale motion capabilities that is responsive to
one location are connected to the monitor in front of the surgeon at a control. It must also be nimble and precise, like the system recently
separate location. The 4G network cannot sufficiently support real-time developed by a team at Vanderbilt University. Precision and a high
image or video streaming during remote surgery, so the faster and more degree of responsiveness also characterize a new microrobot system
stable 5G network will be a significant step forward for implement- by Microsure, used by Maastricht UMC+, an academic hospital in the
ing such procedures. And the internet of things will help connect the Netherlands, to perform a successful microsurgery on the sub-
physicians, virtual-reality tools, robotic arms, imaging equipment, image millimeter vessels in the arm of a lymphedema patient.
processors, data analytics software, and the patient. The result will be a
3D, immersive, and interactive experience for the physician that enables WHAT’S NEXT?
operations to proceed with more ease and precision. Even before the pandemic, medicine was trending toward remote
Experiments with remote consultation and remote surgery in a 5G continuous care for the growing number of patients with chronic
network are under way. In 2019, the Clinic Hospital in Barcelona, Spain, illnesses. Covid-19 has accelerated this trend and extended it beyond
performed the first 5G-enabled remote surgery. Later that year, a surgical outpatient care to surgery. In the future, such challenges as remov-
team at the Endoscopy Center at Japan’s Osaka Hospital collaborated ing blood clots without surgery will be reality rather than the stuff of
graphically with the Digestive System Department of Spain’s sci-fi novels. After a remote consultation with the patient, a physician
Quirónsalud Málaga Hospital, sharing input on how an operation should could prescribe drugs to break up blood clots or might even perform
proceed. Around the same time, a Chinese team performed three simul- catheter-directed thrombolysis — a minimally invasive treatment that
taneous orthopedic procedures using surgical robots and 5G. dissolves abnormal blood clots in blood vessels — remotely.
A note of caution: Even though 5G is superfast, its reliability is an However, multiple roadblocks exist on the way to executing more
absolute requirement during the operation. Any IT or system errors will remote and advanced operations. One hurdle will be to meet the tre-
put the operation and the well-being of the patient in jeopardy. mendous demand for 5G network bandwidth, latency, data security, and
reliability. Also, the costs of robotic arms and operating room connectiv-
MICROSURGERY ity must come down. In addition, surgical training must keep up with the
While minimally invasive surgeries are much more comfortable and technology’s progress. Finally, further miniaturization of instruments
safer for patients than traditional procedures generally are, they and tools is required to enable more flexible and agile operating. ■
demand far greater precision. A surgeon has to work within a very
limited field of vision and maneuver surgical tools and a 3D camera John Koon is a technology writer and an AspenCore contributor.

JUNE 2021 | www.eetimes.eu