Yale professor crucial in first transatlantic surgery

On Fri., Sept. 7, doctors completed the first-ever transatlantic telesurgery, and Richard Satava, a professor of gastro-enterological surgery at Yale Medical School, was instrumental in its success.

STEVE YBARRA/YH Dr. Richard Satava, Yale Medical School professor, played a critical role in the development of the robotic technology used in the first transatlantic surgery.

Satava has been developing surgical robots since 1990. He was initially motivated by the rise of laparoscopic surgery, a procedure that involves making as small of an incision as possible while operating on the abdomen. Because such surgery requires maneuvers in areas hidden from the surgeon's sight, robots can be of great use because they do not rely on a visual sense to operate.

In 1991, Satava went to work at the Defense Advanced Research Project Agency (DARPA), a classified government research program, where robots were developed for battlefield medicine in the absence of human surgeons.

Laparoscopic surgery has recently given rise to telesurgery, a new method of operation that requires no direct physical contact between patient and doctor. In the procedure, a surgeon in one location dictates the precise movements of the robot, which, thousands of miles away, operates on the patient.

The first telesurgery took place in 1997, when the patient and surgeon were both in the same room but not in direct physical contact. And now, just three weeks ago, a team of surgeons at Mount Sinai Medical Center in New York performed a successful gallbladder surgery on a 68-year-old woman who was resting at the Louis Pasteur University in Strasbourg, France.

This surgery was made possible by critical improvements in the accuracy and precision of the robotic technology. Indeed, many feel that robotic surgeons are better than human ones because robots will never tremble or tire. Robots have the potential to perform chest, heart, and nearly all abdominal surgeries.

In an age of increasing specialization within the health-care industry, often the expertise of a doctor and the needs of a patient remain separated by thousands of miles. Robotic surgical practices have the potential to transport life-saving medical technology over great distances without requiring the transport of either patient or doctor. Satava has faith that the new procedure will find quick support: "Like any surgical procedure that is better than before, people will flock to it."

But Rocco Orlando, the director of the Center for Advanced Technology at Hartford Hospital, openly criticized telesurgery. "It's a spectacular technology, but I see no compelling reason not to have a surgeon immediately available," he said. Satava responded firmly to accusations that the technology encourages dehumanization. "Not at all, [telesurgery] is just another tool."

At present, the technology requires a nurse to be at the patient's side to change the instruments of the robot. But this too will soon become unnecessary as the surgeon robots become more self-sufficient. Satava is confident that surgeries will someday take place in the absence of all humans except the patient himself. He sees it as a "fundamental revolution" that is bound to come.

When asked about the intelligence of his robots, Satava replies, "They have a certain amount of intelligence right now. They're about as smart as your refrigerator, but not as smart as your car."

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