Gutsy Robot: Would You Trust R2D2 with a Scalpel?
It looks like a giant bionic fly that has found work as a tailor.
It looms over a small table, moving its black metal arms and silver pincers quickly and silently. Elbows spread wide and camera-lens eyes unblinking, it deftly sews two rubber hoses together.
About 12 feet away, Army Lt. Col. Christoph Kaufmann leans forward in his chair, peering down into a large black box. Below, he holds scissorlike handles at the end of two mechanical arms. He too makes sewing motions.
In fact, every move of his hands is mimicked instantly by the bionic fly.
It’s a little like that scene in “The Wizard of Oz” when Toto pulls back the curtain to reveal the real wizard. And the reality here sounds just as fantastic: The device Kaufmann is demonstrating may one day let surgeons behind the battle lines operate on soldiers at the front.
The bionic fly is called TeSS, for Telepresence Surgery System. The Pentagon has spent about $3 million for its development, and now it’s going to find out what TeSS can do.
Within the next few months, Kaufmann and his military colleagues at the Uniformed Services University of the Health Sciences will start putting it to the test, operating on dummies, cadavers and anesthetized animals. And in two or three years, they’ll have a better idea of how useful it could be on the battlefield.
The idea is to do surgery at the front without putting surgeons in the line of fire. Still, it’s clear that TeSS won’t replace standard surgical care behind the lines, said Kaufmann, a trauma surgeon who sewed up soldiers in Operation Desert Storm.
Soldiers with simple wounds will still wait to be evacuated. If an explosion blows away half a leg, a medic will still apply a tourniquet and get the soldier to human surgeons fast.
But on some future battlefield, a soldier whose lung has collapsed might be hustled into an armored vehicle, where a surgeon-guided robot slips a tube into his chest. His buddy, whose face is so badly damaged he can’t breathe, might inhale again after the robot cuts a hole in his throat.
Some future version of TeSS might help a medic put packing in a ripped-open abdomen to control bleeding, or put a large intravenous line into a soldier’s groin because his arms are too badly burned for a regular IV.
Suppose a bunch of injured soldiers are contaminated by unknown chemical or biological weapons. Or a soldier is wounded by an unexploded shell that lies like a booby trap in his body.
“I think it would be more appropriate to save a surgeon and put a machine at risk,” Kaufmann said.
None of this will happen anytime soon. It could take five to 10 years, Kaufmann said.
Still, TeSS is amazing, said his colleague, Dr. David Burris. Even with a less advanced version, “I’ve operated on a pig three stories down in a parking lot. . . . I could sew his gut together just as well as if I were standing beside it.”
If you peer down into Kaufmann’s black box, grab the scissorlike handles and give TeSS a test drive, you quickly start believing you’re wielding those pincers yourself. It’s like you’re working with two pairs of tongs at a barbecue grill.
You see the pincers on a TV screen, but they appear in three dimensions because of glasses you wear. The pincers respond instantly to your hand motions, and open or close when you manipulate the handles. But most startlingly, you feel what they feel. When a pincer bumps something or pulls the surgical thread taut, you sense the resistance.
The illusion is powerful. Recently, when a reporter tried his hand at operating TeSS, Kaufmann put a needle in one of the pincers and pushed it toward the robot. The reporter jumped back from the box to avoid getting jabbed. Of course, the needle was nowhere near.
TeSS works through a computer that monitors the operator’s movements and sends commands to 28 electric motors in the robot. TeSS is connected to the computer and the black box by a bundle of cables that’s as thick as Kaufmann’s wrist.
And that illustrates a big problem with taking a robot surgeon into the battlefield. Huge amounts of data have to be sent back and forth instantaneously between the robot and the human surgeon. Cables obviously can’t be used in battle, and trying to send this data by present-day radio links would be like running a four-lane freeway into a two-lane bridge.
Technological tricks might overcome that, but there are other concerns: What if the enemy jams the signal during surgery? What if the robot malfunctions?
Burris suspects that improved training for medics might be a better investment than robot surgeons. He warns that if robot surgeons are deployed, training for medics shouldn’t be slighted.
When the technology breaks down, Burris said, there’s a 19-year-old medic on the ground. “If he’s well trained, [he] might be able to save the life of his buddy. If he’s not well trained, he might watch his buddy die.”
In any case, the first and most widespread uses for machines like TeSS may be far from battlefields.
Civilian surgeons might rehearse operations with such a device, programmed to mimic particular patients, Kaufmann said. If real operations were done through a TeSS-like device, it could be set to keep the surgeon out of dangerous territory. Or it could give a surgeon the equivalent of extremely tiny hands for delicate surgery, by greatly magnifying the surgeon’s view while scaling down his motions.
Already, in Europe, a few patients have been operated on with a remote-control surgery device that works through tubes inserted through small holes in the body.
“Within our lifetime, we’ll see benefits,” Kaufmann said. “This technology is not going to go away. It’s too neat.”
