Lord Darzi in his office in London
By Sam Lister, Health Editor
Technology that can “still” a beating heart to allow surgeons to operate robotically on it without the trauma of carrying out a bypass is being developed as part of a series of innovations in surgery.
Lord Darzi of Denham, the Health Minister and a keyhole surgery pioneer, is working on ways to synchronise the movement of the heart with the surgeon’s eye as it continually refocuses on the organ, making it appear still.
The software makes “beating heart” surgery — which reduces the complications associated with stopping the heart to carry out an operation — far easier to conduct. The software is in development, with clinical use planned within the next 18 months.
Professor Darzi will describe the advance, which is being developed with a software scientist at Imperial College London, in a discussion on the future of surgery at The Times Cheltenham Science Festival this evening.
Related Links
* Donor organs for humans from pigs 'closer'
* Can Lord Ara Darzi reform the NHS?
Multimedia
GRAPHIC: keyhole surgery
The surgeon is working on an array of high-tech methods of “minimal access surgery”, which reduces physical and psychological trauma. With cardiac surgery, such as a coronary bypass, the heart is normally stopped and a heart-lung bypass machine is used to oxygenate and circulate blood during the procedure.
However, operating on a beating heart helps to reduce risks linked to reperfusion — when the surgeon has to restart and reintroduce blood to the tissue. Risks include damage to heart muscles and neurological injuries, such as stroke and memory complications.
The algorithms developed by Professor Darzi and Guang-Zhong Yang, a computer scientist at Imperial, involve using cameras to track how a surgeon’s eyes refocus on “fixation points” as the heart expands and contracts.
Using the changes to the eye as focus shifts, scientists can determine “depth perception” and precise dimensions of the moving heart via a robotic laparscope, with the blade then replicating the movements as it carries out an incision. With all elements effectively moving in the same rhythm, the surgeon sees the organ as if still.
Professor Darzi said that “motion compensation” meant that even the complex movement of soft tissue could be tracked.
“It is like looking out the window of a car driving at 70mph and seeing another car travelling alongside at the same speed, and apart from the wheels, it has the appearance of being stationary,” Professor Darzi, codirector of the Hamlyn Centre for Robotic Surgery at Imperial, said. “It allows surgery to be carried out more effectively and precisely.”
Other techniques being developed by Professor Darzi and fellow researchers include a robotic snake that can manoeuvre through orifices to avoid creating external incisions. Another technique involves superimposing scans of the patient’s body, taken before an operation, on to visuals seen by the surgeon, allowing the doctor to “see” behind tissue and organs.
Tens of thousands of prostate, heart and other procedures are already being performed by robots and greater reliance on surgical machines is likely in the future, with their precision reducing trauma and speeding recovery.
Professor Darzi said that the innovations were examples of what the Department of Health hoped to promote with a £220 million fund to support unorthodox NHS work that might transform clinical care. An Innovation Expo is to be held for key NHS and social care staff to learn more about dynamic approaches to science, technology and management.
“In the NHS we are spending £100 billion a year, which needs to involve innovation if quality and productivity are to improve,” he said. However, some critics, including the fertility expert Lord Winston, have questioned the cost-effectiveness of robots when other treatments, such as cancer drugs, are being rationed.
The Cutting Edge: Robot Surgeons at Cheltenham Town Hall (6.30-7.30pm). With Ara Darzi, Brian Davies, a robotics expert, and Robert Winston, Professor of Science and Society.
UNDER THE ROBOTIC KNIFE
The iSnake A mechanical snake that can enter the body through natural orifices such as the mouth, rather than requiring an incision, to perform operations. It can expand to up to 4ft long inside the body.
Motors made of titanium form joints to give it a snake-like appearance and allow the operator to direct it into some of the body’s hardest-to-reach places using delicate sensors, fibre-optic cables and minute cameras. It is designed for use in heart bypass surgery or for diagnosing and operating on problems in the bowels.
Example: when removing a gallbladder, the iSnake moves into the stomach, creates a small incision in the stomach wall, and cuts out the gallbladder, which is then drawn up the throat and out. Researchers say that the only side-effects would be a slightly nasty taste in the mouth.
Augmented reality Surgeons can view not only the insides of the body in 2-D and 3-D, but also by combining images taken preoperatively and then “superimposed” on the body, see through tissue to the organs behind. This helps the surgeon to navigate around the body, providing important additional detail on the location of internal structures and/or pathologies.
Example: the removal of a lung cancer tumour can be carried out with images of the lung surface and images of a scan showing the tumour. With these laid on top of each other, the surgeon can see exactly where the tumour is.
Force constraint Using robots for surgery that have constraints on their movement, so that should the surgeon try to cut somewhere that poses a danger to the patient, the robot will stop.
Example: the removal of a prostate tumour, which can involve incisions close to nerves that, if cut, will leave the patient impotent. Force constraint will stop the incision if a nerve is in danger.
Source: Imperial College
June 3, 2009
UK: Lord Darzi develops robotic ‘beating heart’ surgery
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LONDON, England / The Times / Health / June 3, 2009
Lord Darzi in his office in London
By Sam Lister, Health Editor
Technology that can “still” a beating heart to allow surgeons to operate robotically on it without the trauma of carrying out a bypass is being developed as part of a series of innovations in surgery.
Lord Darzi of Denham, the Health Minister and a keyhole surgery pioneer, is working on ways to synchronise the movement of the heart with the surgeon’s eye as it continually refocuses on the organ, making it appear still.
The software makes “beating heart” surgery — which reduces the complications associated with stopping the heart to carry out an operation — far easier to conduct. The software is in development, with clinical use planned within the next 18 months.
Professor Darzi will describe the advance, which is being developed with a software scientist at Imperial College London, in a discussion on the future of surgery at The Times Cheltenham Science Festival this evening.
Related Links
* Donor organs for humans from pigs 'closer'
* Can Lord Ara Darzi reform the NHS?
Multimedia
GRAPHIC: keyhole surgery
The surgeon is working on an array of high-tech methods of “minimal access surgery”, which reduces physical and psychological trauma. With cardiac surgery, such as a coronary bypass, the heart is normally stopped and a heart-lung bypass machine is used to oxygenate and circulate blood during the procedure.
However, operating on a beating heart helps to reduce risks linked to reperfusion — when the surgeon has to restart and reintroduce blood to the tissue. Risks include damage to heart muscles and neurological injuries, such as stroke and memory complications.
The algorithms developed by Professor Darzi and Guang-Zhong Yang, a computer scientist at Imperial, involve using cameras to track how a surgeon’s eyes refocus on “fixation points” as the heart expands and contracts.
Using the changes to the eye as focus shifts, scientists can determine “depth perception” and precise dimensions of the moving heart via a robotic laparscope, with the blade then replicating the movements as it carries out an incision. With all elements effectively moving in the same rhythm, the surgeon sees the organ as if still.
Professor Darzi said that “motion compensation” meant that even the complex movement of soft tissue could be tracked.
“It is like looking out the window of a car driving at 70mph and seeing another car travelling alongside at the same speed, and apart from the wheels, it has the appearance of being stationary,” Professor Darzi, codirector of the Hamlyn Centre for Robotic Surgery at Imperial, said. “It allows surgery to be carried out more effectively and precisely.”
Other techniques being developed by Professor Darzi and fellow researchers include a robotic snake that can manoeuvre through orifices to avoid creating external incisions. Another technique involves superimposing scans of the patient’s body, taken before an operation, on to visuals seen by the surgeon, allowing the doctor to “see” behind tissue and organs.
Tens of thousands of prostate, heart and other procedures are already being performed by robots and greater reliance on surgical machines is likely in the future, with their precision reducing trauma and speeding recovery.
Professor Darzi said that the innovations were examples of what the Department of Health hoped to promote with a £220 million fund to support unorthodox NHS work that might transform clinical care. An Innovation Expo is to be held for key NHS and social care staff to learn more about dynamic approaches to science, technology and management.
“In the NHS we are spending £100 billion a year, which needs to involve innovation if quality and productivity are to improve,” he said. However, some critics, including the fertility expert Lord Winston, have questioned the cost-effectiveness of robots when other treatments, such as cancer drugs, are being rationed.
The Cutting Edge: Robot Surgeons at Cheltenham Town Hall (6.30-7.30pm). With Ara Darzi, Brian Davies, a robotics expert, and Robert Winston, Professor of Science and Society.
UNDER THE ROBOTIC KNIFE
The iSnake A mechanical snake that can enter the body through natural orifices such as the mouth, rather than requiring an incision, to perform operations. It can expand to up to 4ft long inside the body.
Motors made of titanium form joints to give it a snake-like appearance and allow the operator to direct it into some of the body’s hardest-to-reach places using delicate sensors, fibre-optic cables and minute cameras. It is designed for use in heart bypass surgery or for diagnosing and operating on problems in the bowels.
Example: when removing a gallbladder, the iSnake moves into the stomach, creates a small incision in the stomach wall, and cuts out the gallbladder, which is then drawn up the throat and out. Researchers say that the only side-effects would be a slightly nasty taste in the mouth.
Augmented reality Surgeons can view not only the insides of the body in 2-D and 3-D, but also by combining images taken preoperatively and then “superimposed” on the body, see through tissue to the organs behind. This helps the surgeon to navigate around the body, providing important additional detail on the location of internal structures and/or pathologies.
Example: the removal of a lung cancer tumour can be carried out with images of the lung surface and images of a scan showing the tumour. With these laid on top of each other, the surgeon can see exactly where the tumour is.
Force constraint Using robots for surgery that have constraints on their movement, so that should the surgeon try to cut somewhere that poses a danger to the patient, the robot will stop.
Example: the removal of a prostate tumour, which can involve incisions close to nerves that, if cut, will leave the patient impotent. Force constraint will stop the incision if a nerve is in danger.
Source: Imperial College
Lord Darzi in his office in London
By Sam Lister, Health Editor
Technology that can “still” a beating heart to allow surgeons to operate robotically on it without the trauma of carrying out a bypass is being developed as part of a series of innovations in surgery.
Lord Darzi of Denham, the Health Minister and a keyhole surgery pioneer, is working on ways to synchronise the movement of the heart with the surgeon’s eye as it continually refocuses on the organ, making it appear still.
The software makes “beating heart” surgery — which reduces the complications associated with stopping the heart to carry out an operation — far easier to conduct. The software is in development, with clinical use planned within the next 18 months.
Professor Darzi will describe the advance, which is being developed with a software scientist at Imperial College London, in a discussion on the future of surgery at The Times Cheltenham Science Festival this evening.
Related Links
* Donor organs for humans from pigs 'closer'
* Can Lord Ara Darzi reform the NHS?
Multimedia
GRAPHIC: keyhole surgery
The surgeon is working on an array of high-tech methods of “minimal access surgery”, which reduces physical and psychological trauma. With cardiac surgery, such as a coronary bypass, the heart is normally stopped and a heart-lung bypass machine is used to oxygenate and circulate blood during the procedure.
However, operating on a beating heart helps to reduce risks linked to reperfusion — when the surgeon has to restart and reintroduce blood to the tissue. Risks include damage to heart muscles and neurological injuries, such as stroke and memory complications.
The algorithms developed by Professor Darzi and Guang-Zhong Yang, a computer scientist at Imperial, involve using cameras to track how a surgeon’s eyes refocus on “fixation points” as the heart expands and contracts.
Using the changes to the eye as focus shifts, scientists can determine “depth perception” and precise dimensions of the moving heart via a robotic laparscope, with the blade then replicating the movements as it carries out an incision. With all elements effectively moving in the same rhythm, the surgeon sees the organ as if still.
Professor Darzi said that “motion compensation” meant that even the complex movement of soft tissue could be tracked.
“It is like looking out the window of a car driving at 70mph and seeing another car travelling alongside at the same speed, and apart from the wheels, it has the appearance of being stationary,” Professor Darzi, codirector of the Hamlyn Centre for Robotic Surgery at Imperial, said. “It allows surgery to be carried out more effectively and precisely.”
Other techniques being developed by Professor Darzi and fellow researchers include a robotic snake that can manoeuvre through orifices to avoid creating external incisions. Another technique involves superimposing scans of the patient’s body, taken before an operation, on to visuals seen by the surgeon, allowing the doctor to “see” behind tissue and organs.
Tens of thousands of prostate, heart and other procedures are already being performed by robots and greater reliance on surgical machines is likely in the future, with their precision reducing trauma and speeding recovery.
Professor Darzi said that the innovations were examples of what the Department of Health hoped to promote with a £220 million fund to support unorthodox NHS work that might transform clinical care. An Innovation Expo is to be held for key NHS and social care staff to learn more about dynamic approaches to science, technology and management.
“In the NHS we are spending £100 billion a year, which needs to involve innovation if quality and productivity are to improve,” he said. However, some critics, including the fertility expert Lord Winston, have questioned the cost-effectiveness of robots when other treatments, such as cancer drugs, are being rationed.
The Cutting Edge: Robot Surgeons at Cheltenham Town Hall (6.30-7.30pm). With Ara Darzi, Brian Davies, a robotics expert, and Robert Winston, Professor of Science and Society.
UNDER THE ROBOTIC KNIFE
The iSnake A mechanical snake that can enter the body through natural orifices such as the mouth, rather than requiring an incision, to perform operations. It can expand to up to 4ft long inside the body.
Motors made of titanium form joints to give it a snake-like appearance and allow the operator to direct it into some of the body’s hardest-to-reach places using delicate sensors, fibre-optic cables and minute cameras. It is designed for use in heart bypass surgery or for diagnosing and operating on problems in the bowels.
Example: when removing a gallbladder, the iSnake moves into the stomach, creates a small incision in the stomach wall, and cuts out the gallbladder, which is then drawn up the throat and out. Researchers say that the only side-effects would be a slightly nasty taste in the mouth.
Augmented reality Surgeons can view not only the insides of the body in 2-D and 3-D, but also by combining images taken preoperatively and then “superimposed” on the body, see through tissue to the organs behind. This helps the surgeon to navigate around the body, providing important additional detail on the location of internal structures and/or pathologies.
Example: the removal of a lung cancer tumour can be carried out with images of the lung surface and images of a scan showing the tumour. With these laid on top of each other, the surgeon can see exactly where the tumour is.
Force constraint Using robots for surgery that have constraints on their movement, so that should the surgeon try to cut somewhere that poses a danger to the patient, the robot will stop.
Example: the removal of a prostate tumour, which can involve incisions close to nerves that, if cut, will leave the patient impotent. Force constraint will stop the incision if a nerve is in danger.
Source: Imperial College
