A Telemedicine System for Minimally Invasive Surgeries - Application Towards Surgical Treatment of Cancer and Renal Diseases

OVERVIEW: The goal of this applied research is to develop a telemedicine system to support intraoperative collaboration between a specialist/expert surgeon (who could be remotely located) and an operating surgeon during minimally invasive surgery. The project entails development of immersive, augmented reality-based, enabling technologies that would provide the operating surgeon realistic audio-visual cues from a specialist expert surgeon. The cues will assist the operating surgeon to learn and perform precise movements of the highly-actuated surgical instruments required during a minimally invasive surgery including information related to tool-tissue interaction. As the telemedicine system will provide real-time, interactive intraoperative guidance during the surgery, we hypothesize the usage of such system will facilitate efficient transfer of surgical expertise from the experienced specialist surgeon to the novice operating surgeon. This will improve the surgical outcome especially in case of specialized surgeries for treatment of cancer and renal diseases, expand the reachability, and broaden the spectrum of surgical services, thus potentially transforming the surgical care offered by hospitals. In the proposed applied research, new core technologies that will form the functional building blocks of the tele-medicine system will be pursued by a multidisciplinary team comprising of scientists/engineers (in the fields of computer graphics, human-machine interfacing, computer networking, and system integration) and clinicians (colorectal surgeons, urologists, and transplant surgeons). These core technologies, primarily comprising of human-machine interfacing, augmented reality, and computer networking, will be developed as independent modules and will be integrated together to form a unified telemedicine system during the course of the project. The integrated telemedicine system will be validated by surgeons at Hamad Medical Corporation from different specialties, including Colorectal-Surgery, Urology, and Transplant Unit. The validation studies will aim at assessing the telemedicine system as a surgical education tool as well as user-evaluation for intraoperative tele-mentoring. INTELLECTUAL MERIT: The proposed application-driven research will advance the field of telemedicine for minimally invasive surgeries by developing new enabling/core technologies. Specifically, this research will develop and advance: ▪ Human-machine interfacing technologies to capture and convert surgeon’s hand gesture into virtual surgical tool motion. ▪ Augmentation methods to enhance the surgical view by overlaying motion of virtual surgical tools. ▪ Secure networking protocols to transmit live audio-video streams over the network with packets of augmentation data. ▪ Computational frameworks to integrate the software modules with the hardware components into a single synchronized telemedicine system. The developed technological components of the integrated telemedicine system will be evaluated and clinically assessed by surgeons at Hamad Medical Corporation. This would further improve the understanding and advance the knowledge related to implementation of telemedicine technology for: ▪ Utilization across disciplines related to tele-mentoring, tele-conferencing, and tele-collaboration during a minimally invasive robotic/laparoscopic surgery. ▪ Application to minimally invasive surgical treatments (such as colectomy, radical prostatectomy, partial/radical nephrectomy, living donor nephrectomy, and pyeloplasty) of renal and cancer diseases. ▪ Assimilation into the surgical workflow across hospitals of Hamad Medical Corporation and healthcare services in Qatar. BROADER IMPACTS: The proposed research, by advancing telemedicine technology for minimally invasive surgery, can potentially have significant benefits to both patients and healthcare system in regards to surgical treatment for cancer and renal diseases. The technology will behave as a training tool for surgeons to get trained on new or improved existing MIS techniques / surgical workflows, thus improving the surgical outcome and providing higher quality of surgical care. As the technology facilitates transfer of surgical expertise, it would expand the range of specialized minimally invasive surgical services offered by a hospital to its patients. Thus, improving the capacity building for an integrated healthcare system in Qatar and delivering high impact to the patients and their families.

Hamad Medical Corporation