Robotic Telementoring/Telesurgical System and Randomized Evaluation Study

The paper presents a new telementoring system incorporating audio-video communication and remote robotic control. The system was developed around an off the shelf ISDN video conferencing system enhanced with video annotation and remote robot control features. The user can remotely control a robot of perform needle alignment and insertion in a Percutaneous access procedure. Particular attention was devoted to ensure the safety of the procedure. The data connection is continuously monitored and in the event of a failure the robot control is switched to the local operator. Two series of randomized trials were performed between Baltimore and London. The accuracy and procedure time were evaluated for manual needle placement, local robotic needle placement and remotely controlled robotic needle placement. The test showed that while the procedure time is not improved by the robotic approach there is an improvement in the accuracy of the procedure. The study showed also that there is no significant difference between the locally controlled robotic needled placement and the remotely controlled robotic needle placement. Thus, the proposed system can be safely used for remote robotic percutaneous access procedures.