Richard M. Satava, MD FACSProfessor of Surgery

University of Washington

Program Manager, Advanced Biomedical TechnologiesDefense Advanced Research Projects Agency (DARPA)

andSpecial Assistant, Advance Medical Technologies

US Army Medical Research and Materiel Command

Future of Healthcare Robotics

CyberTherapy 2005 Robotics Session

Basel, SwitzerlandJune 7, 2005

“Prediction is difficult . . .

. . . especially about the Future”

….Yogi Berra

Prediction

Virtual Reality … the promise of the future

1987

Virtual Reality … the realization of the future

2005

Surgeon of the Future ?? Cybertherapist of the Future ??

Wizard of Idby Brant Parker

Superhuman Robots!

The Touch Lab, MITMovie: Alien

“The Future is here …

. . . it’s the Information Age”

Current Visions

HolomerTotal body-scan for total diagnosis

From visible human to Virtual SoldierMulti-modal total body scan on every trauma patient in 15 seconds

Satava March, 2004

Why robotics, imaging and modeling & simulation

• Healthcare is the only industry without a computer representation of its “product”

•A robot is not a machine . . .it is an information system with arms . . .

• A CT scanner is not an imaging systemit is an information system with eyes . . .

thus

• An operating room is an information system with . . .

Total Integration of Surgical Care

Joel Jensen, SRI International, Menlo Park, CA

Minimally Invasive Surgery

Pre-operative planning

Intra-operative navigation

Remote Surgery

Simulation & Training

Remote telesurgery

“Operation Lindberg”

First remote and trans-AtlanticTelesurgery procedure

ROUTINE telesurgery from Hamilton to North Bay

300 mile distant

Prof. Jacques Marescaux, IRCAD Dr. Mehran Anvari, MDMcMaster Univ, Toronto CANADA

“Penelope” – robotic scrub nurse

Michael Treat MD, Columbia Univ, NYC. 2003

Entirely computerized ICU

• Defibrillator• Ventilator• Suction• Monitoring• Blood Chemistry Analysis• 3-Channel Fluid/Drug Infusion•Data Storage and Transmission• On-board Battery• On-board Oxygen• Accepts Off-Board Power and Oxygen

Total Patient Awareness

The LSTAT

Courtesy of Integreated Medical Systems, Signal Hill, CA

LSTAT Deployment to Kosovo - March 2000212th MASH Deployed with LSTAT - Combat Support Hospital

Courtesy of Integreated Medical Systems, Signal Hill, CA

Why now?VTOL UAV technology is maturing rapidly enough to minimize risk.

Nightingale UAV GoalIdentify

“optimum” VTOL UAV design

Create a new VTOL UAV tailored to the operational need

LSTAT

Or:

Robotic Medical Assistant

SATAVA 7 July, 1999DARPA

Nursing shortage crisis

Applicable at all levelsHospitalsClinicsNursing HomeAssisted living

Courtesy Yulun Wang, InTouch Technologies, Inc, Goleta, CA

Honda Humanoid Robot Asimo Honda Motor Company, Tokyo Japan

“Blue Dragon” passive recording device

Courtesy Blake Hannaford, University of Washington, Seattle

Hand motion tracking patterns Ara Darzi, MD. Imperial College, London, 2000

Objective AssessmentNovice

Intermediate

Expert

Integrating Surgical Systems for AutonomyThe Operating Room (personnel) of the Future

Surgeon Assistant Scrub Nurse Circulating nurse

100,000

Satava March, 2000

The Operating Room of the Future

Predator 2003Fighter Pilots – until 2002 Fighter Pilots – Beyond 2003

SATAVA 7 July, 1999DARPA

“The Future is not what it used to be”

….Yogi Berra

Disruptive Visions

DARPA Controlled Biological Systems Program

Animats Machine Living AnimalsAnimats Machine Living Animals

•Integration of biological designfor sensorimotor function

•neural control architecture•biomechanical self-stabilization•sensor/performance

•Autonomous navigation

•Modular design/fabrication offault tolerant mobile sensorplatforms

•New interfaces for measuringneural-muscular outputs sensorimotorcontrol in freely moving/sensing behaving biological systems

•Stimulation of neural and muscular systems to influence sensorimotorfunction

•Inexpensive attachment of sensors(chem/bio)

•Pheremone control ofsensorimotor output - plumetracing

•Plasticity of associativelearning to threats of interest(conditioned training)

•Investigate behavior withsensor motor architecture

Biomimetic Systems Biohybrid Organisms Biological Systems

Courtesy Alan Rudolph, Program Manager, 1999

Biomimetic robot - Ariel

Biomimetic Micro-robot

Courtesy Sandia National Labs

Capsule camera for gastrointestinal endoscopyCourtesy Paul Swain, London, England

Femtosecond Laser(1 x 10 –15 sec)

Los Alamos National Labs, Los Alamos NM

Time of Flight Spectroscopy

Cellular opto-porationCold Spring Harbor Laboratory, Long Island, NY

BioSurgery

Satava September 2003

Confidential

Technologies will change the Future

• The rate of new discovery is accelerating exponentially

• The changes raise profound fundamental issues

• Moral and ethical solutions will take decades to resolve

Differing responses to scientific discovery by various sectors

TIME

Rat

e of

Cha

nge

Society

Business

Sector

Technology

Healthcare

And just what are these profound moral and ethical issues?

Gaak

Courtesy Professor Noel Sharkey, Sheffield Unversity, London

"Thinking" robot in escape bidScientists running a pioneering experiment with

robots which think for themselves have caught one trying to flee the centre where it "lives".

The small unit, called Gaak, is one of 12 taking part in a "survival of the fittest" test at the Magna science centre in Rotherham, South Yorkshire, which has been running since March.

Gaak made its bid for freedom after it had been taken out of the arena where hundreds of visitors watch the machines learning how to repair themselves after doing daily battle.

Professor Noel Sharkey said he turned his back on the drone, but when he returned 15 minutes later he found it had forced its way out of the small make-shift paddock it was being kept in.

He later found it had travelled down an access slope, through the front door of the centre and was discovered at the main entrance to the car park when a visitor nearly flattened it with his car.

TECHNOLOGY NEWS

Intelligent “Living Robot”Uses genetic algorithms to “learn”

Kismet

Courtesy Rosalind Picard, MIT Affective Computing Lab, Boston, MA

ESCAPED

Ray Kurzweil

Humans vs Machine

Humans 4.0X10 19 cpsRed Storm 3.5X10 15 cps

Moore’ s Law“computer power doubles

every 18 months”

Do the Math !!

Who is smarter now??

ROBOTHans Moravec

The Age of

Spiritual

Machines

WHEN COMPUTERS EXCEEDHUMAN INTELLIGENCE

Will Machines become “smarter than humans?

Do Robots Dream ?