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Surgery by Zoom? It may be closer than you think

Hack Reactor

Surgery by Zoom

By Peter Suciu For Hack Reactor

Nearly a year into the global Covid-19 pandemic, the way that telemedicine is being used has changed forever. The pandemic, which resulted in many people avoiding hospitals and even their doctor's offices, has sped up the use of Zoom, Skype, and other video IP platforms and software used by healthcare providers.

One aspect of telemedicine has been in how doctors and others in healthcare can connect with patients remotely, while the use of fitness-monitoring devices and health tracking software can allow some of a patient's vital signs including heart rate and blood pressure to be monitored remotely.

"Clearly, VoIP technology has been available for some time but utilization/adoption has varied," explained Dr. Binoy K. Singh, MD, Fellow, American College of Cardiology (FACC).

"The pandemic has forced a large swath of professional and personal communications to take place via these platforms," added Singh. "Since March of 2020, the use of VoIP platforms have flourished, impacting almost every aspect of healthcare systems e.g., clinical care, education, delivery and access, operations, strategy development, etc."

Zoom In

It isn't just diagnosis that is changing, as surgeons are embracing the ability to engage in telesurgery as well.

Last July, a doctor took socially distant surgery to a new level when he utilized a 5G network to perform a remote operation as part of a test study. The report, published in the Annals of Internal Medicine, highlighted how it was possible for an expert otorhinolaryngologist in Milan, Italy to use robotic technology and 5G to operate on a cadaver located nine miles away.

The low latency and high bandwidth of 5G, along with a 3D display and advanced surgical robot, allowed the doctor to perform the operation remotely. Two assistants helped by preparing the patient/cadaver while they also controlled the surgical laser parameters. The success of the test demonstrated the feasibility of remote surgery in emergency situations but also in everyday use.

It could allow for surgeries to be conducted in temporary field hospitals without transporting the surgeons to the actual facility. It could open up the possibility of physical distancing that may be necessary in times such as the current pandemic.

The test from last summer was far from the first, and telesurgery involving a human patient was first done in 2001, when a surgeon in New York completed a laparoscopic cholecystectomy on a patient in Strasbourg, France. However, in the two seconds since the technology has certainly advanced, and while not quite becoming the new normal, it could be on its way thanks to 5G, artificial intelligence (AI), and improved robotics.

The Military Leads the Way

Not surprisingly, the U.S. military has been at the forefront of this technology, as remote surgery could be used on/near future battlefields – and that could save lives. Soldiers could be on the surgical table within minutes of receiving a life-threatening wound instead of the hours it can take now.

"Remote-controlled robotic surgery has been in development for a decade or more with many advances coming out of DARPA and other Department of Defense (DoD) groups," said technology analyst Charles King of Pund-IT.

"The benefits for military applications are clear, given the clear benefits of quickly performing procedures near where a soldier is wounded rather than airlifting him/her to an advanced medical facility," added King. "Plus, the armed forces have the funding for the robust, secure wireless networks and technologies needed to support robotic surgery."

Greater Civilian Adoption

It won't take a "swords to plowshares" transition to bring telemedicine, including surgeries, to the civilian world. The last few years have already seen a shift where patients can be diagnosed and even treated remotely. And as noted, with the adoption of 5G networks, high-resolution virtual reality/augmented reality (VR/AR) headsets, and faster computing power soon surgeons may be able to conduct delicate procedures without leaving their offices.

"Remote surgical interventions utilizing robotics and virtually controlled devices with real time communications is already here," said Singh. "DaVinci technology is just one example of a remote, virtual, robotically driven procedural platform being utilized to perform clinical interventions in rapidly growing numbers today."

This could allow surgeons to reach remote communities so that patients don't need to travel significant distances for some procedures.

"Use cases range from enabling access to skilled subspecialist surgeons who practice miles away from patients in need to broadening care options to people in rural or remote communities," suggested King.

This could present new opportunities for those with the technical skills to support such software and platforms. It is likely that in the future, just an anesthesiologist is there to evaluate, monitor, and supervise patient care before, during, and after surgery, there will need to be someone to monitor the telemedicine platforms and systems.

There are still issues to resolve, including latency and cybersecurity.

"Latency shouldn't be an issue with 5G but deploying the necessary infrastructure to support 5G will be a significant challenge, especially in rural and remote communities which have long been on the wrong side of the 'digital divide,'" added King. "Security is also a concern but should be achievable if 5G carriers and healthcare facilities collaborate and agree on workable standards."

While this technology is already being employed, it could become even more common in just a few years.

"It's possible that we may see some advances in the next two to three years as 5G is deployed in U.S. urban and suburban areas," said King. "It will also be worthwhile to track remote robotic surgery developments in China, the EU, and other areas that tend to be proactive in developing and deploying next-gen wireless technologies."