Dr. Ryan Madder, an interventional cardiologist at Grand Rapids, Mich.-based Spectrum Health, for the past seven years has been researching whether a doctor could perform vascular surgery on a patient from afar using remotely controlled robotic surgical systems. Ideally, that could help speed time to treatment if a patient is far away from a hospital with a specialist.
When a patient is having a heart attack, every minute until treatment counts. “The longer that the artery is closed, the worse that patient does, the higher the risk that the patient is going to die from that heart attack (and) the more damage gets done to their heart,” he said.
Initially, Madder’s research into robot-assisted telesurgery involved testing whether a doctor could control a robotic surgical system from one room over.
But the advent of new internet generations, such as with 5G, has opened up possibilities for performing a procedure from many miles away.
In surgery, any delay between a physician’s motion and the robotic system’s reaction could be disastrous—so 5G’s low latency is a particularly promising attribute.
In 2019, he simulated a minimally invasive heart procedure that spanned more than 3,000 miles through a project with Verizon. Madder, stationed just outside of Boston, remotely controlled a robotic system from Siemens Healthineers company Corindus—another partner on the project—to operate on vascular simulators in San Francisco.
Madder tested performing the procedure—a percutaneous coronary intervention—from Boston to San Francisco using a wired network and a 5G wireless network.
While the procedures had slightly greater latency compared with remote surgeries that spanned a shorter distance—from Boston to New York City, which are only about 200 miles apart—the perceived latency for the Boston-San Francisco procedure was still “imperceptible” to Madder on both the wired and 5G wireless networks, according to study results published last year in the journal Catheterization and Cardiovascular Interventions.
“Based on the results of that study, I don’t think distance is a significant barrier for what we’re going to be able to accomplish in the future for telerobotics in healthcare,” Madder said. “It’s very possible that telerobotics could almost be connected from any location in the U.S.”
Madder’s foray into 5G wasn’t the first experiment to test robot-assisted telesurgery with 5G. A surgeon in China performed a robot-assisted telesurgery in 2019, albeit on a laboratory animal, and a surgeon in Italy that same year directed a surgery from afar over a 5G network.
But there’s still more research needed before integrating robot-assisted telesurgery that spans such a far distance into patient care, including continuing to validate the technology and addressing questions like medical licensure and cybersecurity. Madder said he’s not sure how far off the healthcare industry is from seeing robot-assisted telesurgery become standard in patient care.
“The thing that’s very clear to me is that the technology currently exists to allow this to happen,” he said. “The technology is there. We just need to continue to understand how to best apply it.”