From a distance there is surgery


Now surgery from a distance may become a more pervasive reality thanks to a touch-simulation toolkit created by a Canadian software firm.

Waterloo, Ont-based Handshake VR Inc. says using its flagship product – proSENSE Virtual Touch Tool Box – developers will be able to create haptic-enabled applications that make procedures such as long-distance surgery more commonplace.

And that would soon allow doctors to reach out and “touch” patients thousands of miles away, the company says. Haptics – originating from the Greek word haptikos (able to touch) –refers to working with the sense of touch.

The proSENSE haptic interface integrates tactile capabilities with computer technology, simulating the sense of touch in a variety of situations. Experts say this is a more complex application of the “vibration” feature seen in the joysticks used in certain computer games.

Tele-surgery has been around for sometime, but for the most part it is mostly aided by visual tools.

Haptic devices add a dimension of “touch” that may be very valuable for certain procedures.

“For instance, if the procedure of injecting a patient is being simulated, the user will actually feel the sensation of slight resistance as the needle pierces the patient’s skin,” said Tim Ellis, vice-president of operations and co-founder of Handshake.

He said this feedback is transmitted by devices capable of resisting motion that are controlled by computer instructions. With appropriate programming, the device can be made to behave as if it is touching physical objects not actually present.

Handshake demonstrated this capability during a tele-surgery experiment carried out in 2004 by the National Aeronautics and Space Administration in an underwater laboratory off the coast of Key Largo in Florida. During the project, dubbed NASA Extreme Environment Mission Operations or NEEMO, certain procedures were conducted while replicating conditions on Mars.

In one experiment, for instance, a non-medically trained astronaut set a fractured bone on a simulated patient, guided by a surgeon located at St. Joseph’s Hospital in Hamilton, Ont.

Using haptic devices, linked via the Internet, the surgeon directed the astronaut through the process of attaching stabilizing metal pins on the model of a fractured limb.

The surgeon was able to receive tactile feedback from whatever the astronaut’s device touched. The astronaut in turn, could feel the doctor’s guiding movements transmitted to his haptic device.

This ability to transmit the sense of touch over networks is what sets Handshake apart from other systems, according to Ellis.

He said Handshake has developed the TiDec time delay compensation software that significantly reduces the delay in online transmission of data packets. “When operating on a person, even milliseconds of delay could have dire consequences.”

The network capability is especially useful to David Wang, professor of electronics and computer engineering at the University of Waterloo.

Wang’s students are working on on developing a variety of haptic applications using proSENSE. “Without the network capability the technology wouldn’t fly.”

The Handshake system can facilitate online training of medical students on surgery procedures and rehabilitation exercises for patients.

“Instructors or therapists need not be present with the student or patient,” said Wang.

For instance, he said patients afflicted with Parkinson’s disease can do hand coordination exercises using a haptics device called Omni stylus to trace figures, while guided by a therapist from another location.

Omega stylus has been developed by a Wayburn, Mass-based haptics firm called SenseAble Technologies Inc.

Wang said the proSENSE software also drastically reduces expenses and time required to develop rehabilitation instruments, since it allows developers to build such devices virtually. “If we need a box, we don’t need to construct one with wood, we simply program in the dimensions.”

Patients who need to handle the “virtual box” use the haptic device to “feel” the object.

“This has reduced our development time ten fold,” Wang said.

Ellis foresees promising proSENSE-based applications in the military aerospace, medical and entertainment sectors.


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