Science / Medicine : Robots to the Rescue : Robots have emerged from the assembly line. They now help perform brain surgery, read for the blind and even help quadriplegics live more productive lives.
Blinded during his military service, Ron Miller completed college and earned a doctorate in history by using Braille, books recorded onto cassette tapes and volunteers who read to him. When Miller landed a job with the U.S. Department of Labor in Sacramento, he required a sighted secretary to read documents aloud.
But in October, 1983, the U.S. Veteran’s Administration gave Miller a Kurzweil Reading Machine. The machine’s ‘eye’ scans letters, reports, books and other materials and reads aloud in a synthesized voice. A big-ticket item that costs $19,800, the reading machine has an optical recognition system that reads almost any printed matter. About 800 are in use worldwide.
Miller, now 52, is executive director of the Blinded Veterans Assn. in Washington and is much more independent and efficient on the job.
Jeff Duran, a 28-year-old programmer-analyst at Boeing Computers in Seattle, is a quadriplegic who works full time at a prototype work station that obeys voice commands. A robotic arm reaches for--and opens--work manuals, puts discs into his computer and turns book pages. Prab Robots of Kalamazoo, Mich., is commercializing the technology.
The machine that reads for Ron Miller and the work station that reaches for Duran are only two of the innovative robotic devices being developed and used today. While many are already in use, a number of them, particularly those that might help quadriplegics, are still in the research stage.
“There are two, perhaps three, quadriplegics in the United States today who hold down full-time jobs thanks to experimental roboticized work stations,” said a leading robotics researcher, K. G. Englehardt, director of health and human services in Carnegie Mellon’s Robotic Institute in Pittsburgh. “The few work stations that exist are very expensive, one-of-a-kind prototypes.
“My biggest frustration in life is knowing about these ‘smart devices’ that stay in research for ten years.”
Among the “smart” devices that “see” for the blind include accurate thermometers that “speak” in centigrade or Fahrenheit, talking scales for milling machines, gauges, calipers and other talking machine tools. Some sightless vendors use talking cash registers and a paper money identifier that scans U.S. currency and announces the denomination. The device reads the bill with a microprocessor regardless of the direction the bill is inserted.
Under study at the American Foundation for the Blind is a portable, wallet-sized money identifier. Close to completion is a portable wand that reads and then speaks with LED displays--those red-lighted dials on microwave ovens, clocks, bathroom scales and other instruments.
Johns Hopkins developed for the Veteran’s Administration a workstation like Duran’s. That model has a robotic arm that will also feed the user with a spoon that dips into three bowls. The system has been tested since 1982 and is now being bid on by manufacturers. When mass-produced, the work station is expected to cost about $15,000.
Other automatons assist surgeons, carry supplies in hospitals, do boring tasks in labs and deliver precise amounts of medication inside the body.
For instance, a first surgical robot is used in delicate brain surgery at Memorial Medical Center in Long Beach as the neurosurgeon’s steady-handed assistant. Developed by 41-year-old Yik San Kwoh, director of imaging research at Memorial, the arm is one commonly used in heavy industry. But when coupled with sophisticated X-ray scanning devices and a computer, the arm, named “Ole” after a hospital benefactor, biopsied a tumor deep in a man’s brain. Since then, Ole has been used on 24 other people. The arm dramatically reduces costs and recovery time for patients.
“The arm is safer, faster, and destroys less brain tissue than other surgical procedures,” Kwoh said. “And it is more accurate and steady than any human hand could ever hope to be.”
The robotic arm “sees” because it is connected via computers to a CAT scanner, a device that views the interior of the body far more accurately and realistically than an ordinary X-ray.
In the operating room, a metal ring, marked with reference points, is fitted around the patient’s head. Ring and patient are then put under the CAT scanner. That produces a three-dimensional image of the patient’s skull and brain, along with the ring, on a video screen. If the surgeon is operating on a tumor or blood clot deep in the brain, he uses a tracking device, similar to that in a video game, to put a cross-hair on the target. Commands are given on the computer and the robotic arm goes into position with a drill after the surgeon decides the best entry site. The resulting hole into the skull is smaller than what is usually created in such surgery.
The arm can be swung away from the patient but will return exactly to the same coordinates. Ole can then be fitted with probes, needles, catheters or other instruments, depending on the procedure. The arm can also place tiny radioactive pellets, used to kill tumors, deep in the brain. Ole’s joints are equipped with brakes that stop motion immediately if the power fails.
Kwoh is adapting the robotic arm for back injury cases that require injection of medication into ruptured discs. Extreme steadiness is necessary because there is very little space between discs in the human spine. Other possible uses for Ole include microsurgery on torn ligaments and cartilage.
But in other industries, the traditional task of the robot is not nearly as glamorous as working in the operating room. The customary chores of the robot have been the dirty, the dangerous and the boring.
And what could be more boring than pushing carts loaded with linens, meals and other supplies through the endlessly long halls of hospitals? So the University of Michigan Medical Center, a 586-bed hospital at Ann Arbor, installed “robocarriers” for those chores. “Robos” with flashing orange safety lights follow at 1.5 m.p.h. tracks buried in the floor and catch their own elevators to other floors. The “electronic mules” are programmed to halt if a bumper is depressed, if the load shifts, if the cart is improperly loaded or if the vehicle goes off the guide path.
A robocarrier runs for eight hours on a full charge of electricity and automatically returns to its parking area, where it is recharged. One of the 7-foot-long carts hauls up to 800 pounds of material. One robo chore is collecting the seven tons of trash that the hospital produces daily. The carts also tote dirty and clean dishes, bulk food, patient meals (the carts are given an alcohol wash after hauling trash,) linens, gowns, towels and medical supplies.
Two minicomputers control the system, which is designed so that patients and visitors rarely see the busy robocarriers. The automated system is not used in many hospitals because it is expensive--$3.5 million--and the saving doesn’t start until after 10 years.
Danbury Hospital in Connecticut is installing Helpmate, whose tasks will be delivering meals, collecting samples for the lab and retrieving medical records. A potential application is pushing wheelchairs and helping patients walk. Helpmate understands simple commands, uses elevators and navigates busy hallways on its own. The device has a map of the hospital stored in its brain and a sensory system so it won’t bump into people or objects.
The Institute of Rehabilitation and Research at Baylor College of Medicine in Houston has outfitted a $4,500 Hero 2000 robot with extra sensors, navigational devices and a longer than usual arm.
“Capuchin monkeys, the type the old organ grinder on the street corner used to collect money, have been used for years to pick things up for quadriplegics,” said John Cheatham, a professor of mechanical engineering from Rice University. “We would be happy if (the Hero 2000) could do half as much.”
The robot obeys voice commands and finds its way around a room via triangulation with three ordinary room lights.
Other robotic arms are used as prostheses for people who have lost limbs, or in biotechnology laboratories, where there can be as many as 1,200 separate steps in a testing, screening or weighing procedure. For the lab, specialized “hands” have been developed to hold small vials and large test tubes.
In addition, researchers have developed for heart attack patients the Automatic Implantable Cardioverter-Defibrillator, which monitors the beating of the heart. When there is an irregularity in the heart’s rhythm, the device zaps the organ with enough electric current to restart a normal heart beat.
Other “smart” devices are implanted just under the skin and deliver just the right amount of medication to the location where it’s most needed. That creates fewer side effects and makes the medication more effective. Some have batteries that can be recharged through the skin and some have communication systems that produce print-outs on external printers.
It may be many, many years before a flashing automaton like R2D2 or 3CPO whirs into your waiting room and asks you to “input” your symptoms, but robots increasingly are entering the world of medicine--an arm, an eye and a hand at a time.
