Precision Guided Surgery

1. IDEAS
Innovation,
Design, and
Emerging
Alliances in
Surgery
March 28, 2015
BOSTON, MA
www.ideasprojectharvard.org
TM
Surgical Robotics:
Defining Grand Challenges
for Surgery and Robotics
IDEAS is a program of the
Roberta and Stephen R. Weiner
Department of Surgery at
Beth Israel Deaconess Medical Center

2. Welcome to the fifth annual IDEAS Symposium
As the name suggests, IDEAS fosters and provides an interactive forum for
innovation at the interface of surgery and other disciplines—whether the
social, biological, or physical sciences—with the goal of improving the lives of
patients worldwide.
This year’s symposium, “Surgical Robotics: Defining Grand Challenges for
Surgery and Robotics,” is a unique event that brings together surgeons,
engineers, and thought leaders from across the United States and Europe.
Our speakers will share cutting-edge ideas and research that we hope will
spark innovation, original concepts, and novel ideas.
Topics will include government priorities in robotics, tissue modeling and
steering, and more. The day’s discussions will also touch on the use of
robotics in clinical practice, the barriers to its use, and the next generation of
surgery systems.
This year we will feature an engaging poster session. Relax at the end of
a full day with complimentary cocktails and hors d’oeuvres while learning
about the cutting-edge research occurring in the field of surgical robotics.
Poster categories include: Robotic-Surgeon Interface, Human-Machine
Replacement and Assistive Bioprosthetics, and Robotics in Surgical Practice.
Thank you for attending and welcome to Boston.
Elliot Chaikof, MD, PhD Henrik Christensen, PhD
Co-Leader Co-Leader
IDEASINNOVATION, DESIGN, AND EMERGING
ALLIANCES IN SURGERY
TM

3. IDEAS™ (Innovation, Design, and Emerging Alliances in Surgery) Symposium
Surgical Robotics:
Defining Grand Challenges for Surgery and Robotics
Saturday, March 28, 2015
Joseph B. Martin Conference Center at Harvard Medical School
Rotunda Room, 3rd Floor
77 Avenue Louis Pasteur
Boston, Massachusetts 02115
7:30 – 8:25 AM Breakfast and Registration
8:25 – 8:30 AM Introduction
Henrik Christensen, PhD (Georgia Institute of Technology) and
Elliot Chaikof, MD, PhD (BIDMC/Harvard)
8:30 – 9:15 AM Keynote Presentation: Robotics, Science, and Society:
Views from Washington
• Jeffrey Trinkle, PhD (Rensselaer Polytechnic Institute/NSF) l
NSF Priorities in Robotics
9:15 – 10:30 AM Session 1: The Robot-Surgeon Interface
• Ken Goldberg, PhD (UC Berkeley) l Learning by Observation for
Surgical Subtasks: Multilateral Cutting of 3D Viscoelastic and 2D
Orthotropic Tissue Phantoms
• Stefano Stramigioli, PhD (University of Twente) l Robotic Endoscopy
10:30 – 11 AM Break
11 AM – 12:30 PM Session 2: Human-Machine Replacement and Assistive
Bioprosthetics
• Brenna Argall, PhD (Northwestern) l Turning Assistive Machines into
Assistive Robots
• Michael Goldfarb, PhD (Vanderbilt) l Next Generation Exoskeleton
Systems
• Brian Scassellati, PhD (Yale) l Using Robots in the Diagnosis and
Treatment of Autism
12:30 – 2:00 PM Buffet Lunch and Poster Session
2 – 3:30 PM Session 3: Robotics in Practice: Realizing Clinically Meaningful
Advances
• A. James Moser, MD (BIDMC/Harvard) l Challenges in Robotic
GI Surgery
• Alan Lumsden, MD (Houston Methodist DeBakey Heart & Vascular
Center) l Robotic Technology in Endovascular Surgery
• Yusef Kudsi, MD, MBA (Tufts) l The Robot as a Surgical Assistant
3:30 – 4 PM Discussion and Closing Remarks: Defining the Grand Challenges
for Surgery and Robotics
4 – 6 PM Poster Session and Reception

4. IDEASTM (Innovation, Design, and Emerging Alliances in Surgery)
Surgical Robotics: Defining Grand Challenges for Surgery and Robotics
Saturday, March 28, 2015
Boston, MA
Poster Session
I. Robotic-Surgeon Interface
Live Stream, Remote Telementoring, Teamwork & Training with Multisensory Surgical Vismemes
Jim Smurrol, George Haleblian2, and Shaan Gandhi3
1VisMedX, 2Prime Biomedical Consulting,
3
Harvard Medical School and Harvard Business School
H. Human-Machine Replacement and Assistive Bioprosthetics
Restoring Hand Function By Designing Implantable Artificial Tendon Networks for Surgery
Kamin Beyer", Taymaz Homayouni2, Ravi Balasubramanian2, and Christopher H. Allan3
'School of Chemical, Biological, and Environmental Engineering, Oregon State University; School of Mechanical,
Industrial, and Manufacturing Engineering, Oregon State University; 3Department of Orthopaedic Surgery,
University of Washington Medical Center
A New Concept of Complex Single Step Skull Reconstruction in Osteolytic Skull Diseases
Victoria Ohla1'2, Ahmed B. Bayoumi2, Markus Hefty3, Matthew Anderson3, and Ekkehard Kasper?
'Department of Neurochirurgie, Universitatsklinikum Essen, Germany; Division of Neurosurgery, Beth Israel
Deaconess Medical Center; 3Department of Pathology, Beth Israel Deaconess Medical Center
Shape Deposition Manufacturing of a "Smart," Atraumatic, Deployable Grasper for Minimally Invasive Pancreas
Surgery
Ammara A. Watkins1'3, Courtney Barrows13, Joshua Gafford2, Ye Ding2, Andrew Harris2, Terrence McKenna2,
Panagiotis Polygerinos2, Donald Hollands, Conor Walsh2'4, and A. James Moser1'3
'Pancreas and Liver Institute, Beth Israel Deaconess Medical Center; 2Harvard University Schools of Engineering
and Applied Sciences; 3Harvard Medical School; 4Wyss Institute for Biologically-Inspired Engineering; 5Trinity
College, Dublin, Ireland
III. Robotics in Surgical Practice
Design and Control of a Robotic System for Microsurgery
Alperen Degirmencil, Frank L. Hammond 1111, Joshua Gafford2, Conor J. Walshl'3, Robert J. Wood1'3, and Robert D.
Howe'
'Harvard School of Engineering and Applied Sciences; 2BioDesign Lab, Harvard University; 3Wyss Institute for
Biologically Inspired Engineering
Progress towards a Clinically-Ready Transnasal Concentric Tube System
Hunter B. Gilbert', Ray A. Lathrop', Richard J. Hendrick', and Robert J. Webster 1111
Vanderbilt Initiative in Surgery and Engineering, Vanderbilt University
Page 1 of 2
IDEASTM (Innovation, Design, and Emerging Alliances in Surgery)
Surgical Robotics: Defining Grand Challenges for Surgery and Robotics
Saturday, March 28, 2015
Boston, MA
Poster Session
I. Robotic-Surgeon Interface
Live Stream, Remote Telementoring, Teamwork & Training with Multisensory Surgical Vismemes
Jim Smurrol, George Haleblian2, and Shaan Gandhi3
1VisMedX, 2Prime Biomedical Consulting,
3
Harvard Medical School and Harvard Business School
H. Human-Machine Replacement and Assistive Bioprosthetics
Restoring Hand Function By Designing Implantable Artificial Tendon Networks for Surgery
Kamin Beyer", Taymaz Homayouni2, Ravi Balasubramanian2, and Christopher H. Allan3
'School of Chemical, Biological, and Environmental Engineering, Oregon State University; School of Mechanical,
Industrial, and Manufacturing Engineering, Oregon State University; 3Department of Orthopaedic Surgery,
University of Washington Medical Center
A New Concept of Complex Single Step Skull Reconstruction in Osteolytic Skull Diseases
Victoria Ohla1'2, Ahmed B. Bayoumi2, Markus Hefty3, Matthew Anderson3, and Ekkehard Kasper?
'Department of Neurochirurgie, Universitatsklinikum Essen, Germany; Division of Neurosurgery, Beth Israel
Deaconess Medical Center; 3Department of Pathology, Beth Israel Deaconess Medical Center
Shape Deposition Manufacturing of a "Smart," Atraumatic, Deployable Grasper for Minimally Invasive Pancreas
Surgery
Ammara A. Watkins1'3, Courtney Barrows13, Joshua Gafford2, Ye Ding2, Andrew Harris2, Terrence McKenna2,
Panagiotis Polygerinos2, Donald Hollands, Conor Walsh2'4, and A. James Moser1'3
'Pancreas and Liver Institute, Beth Israel Deaconess Medical Center; 2Harvard University Schools of Engineering
and Applied Sciences; 3Harvard Medical School; 4Wyss Institute for Biologically-Inspired Engineering; 5Trinity
College, Dublin, Ireland
III. Robotics in Surgical Practice
Design and Control of a Robotic System for Microsurgery
Alperen Degirmencil, Frank L. Hammond 1111, Joshua Gafford2, Conor J. Walshl'3, Robert J. Wood1'3, and Robert D.
Howe'
'Harvard School of Engineering and Applied Sciences; 2BioDesign Lab, Harvard University; 3Wyss Institute for
Biologically Inspired Engineering
Progress towards a Clinically-Ready Transnasal Concentric Tube System
Hunter B. Gilbert', Ray A. Lathrop', Richard J. Hendrick', and Robert J. Webster 1111
Vanderbilt Initiative in Surgery and Engineering, Vanderbilt University
Page 1 of 2

5. TITLE: Surgical Telementoring, Teamwork & Training with Interactive Streaming Video & Multisensory Augmented Reality
AUTHORS: Jim Smurro, MS, MBA; George Haleblian, MD; and Shaan Gandhi MD, MBA (2015)
ABSTRACT:
Surgeons learn by mimicking the actions of their mentors. True collaboration in surgery involves not merely knowing when and where
to cut, but also with what force, speed, and direction. We approached this problem by combining the video of a traditional
telemedicine application with the physics engine of a 3D medical simulation. This allowed us to recreate an object from a medical
image as a live stream interactive, virtualized object on the computer. Surgeons can use virtual scalpels and forceps to annotate live
and recorded surgical video as if they were manipulating actual tissue. This is not simply surgical simulation, but rather, true surgical
demonstration. Rather than simply describing the surgical maneuver, surgeons can virtually ‘show & share’ the procedure with others
- remotely, in real time, in a realistic manner, on a live patient, with haptic feedback that mimics human tissue response.
We tested SurgiStreams™ with several surgical cases, including live stream telementoring of a retroperitoneal lymph node dissection
with the daVinci Si surgical platform. SurgiStreams™ enabled surgical telecollaboration with mentors while performing the RPLND.
The mentor was able to virtually demonstrate the use of the daVinci forceps, scalpel, and suture, and could visually describe the force,
speed and direction of the instrument maneuvers to the primary surgeon in a natural way.
SurgiStreams™ 2.0 capabilities have been extended with clinical trial and use, and now include: surgeon voice-activated command;
audio annotation & tagging for clinical notation; multipoint audio for both in-theater and networked telementors; secure data stream
encryption for high resolution, low latency broadcast over LAN & WAN; multi-channel live stream; archived (relevant prior) surgical
video available for intraoperative consultation; perioperative [pre, post & intraoperative] imagery integration with multimodal
imaging, waveforms & video; haptic tissue/video manipulation with Hydra joysticks.
SurgiStreams™ 2.0 can now record, annotate, tag and save multisensory surgical vismemes as packetized “sight-touch-sound”
teaching files for “See One. Do One. Teach One.” augmented reality instruction.
Telementoring, teamwork and training with virtualized haptic devices such as SurgiStreams™ can redefine “See One. Do One. Teach
One.” surgical instruction. Networked training programs can live stream surgery cases, utilizing them as interactive surgical
whiteboards when training residents or testing new operative techniques. Multimodal cognitive instruction with multisensory surgical
vismemes can enhance pre-operative surgical planning, intraoperative surgical decision-making, and post-operative clinical review,
accelerating the acquisition of specialist surgical skills.
Ŧ
L’Esperance JO et al. Telementoring in Robotic Surgery. Curr Opin Urol 2013, 23:141–145
The authors wish to thank the surgeons and clinical teams at USC Keck Norris Comprehensive Cancer Hospital, USN Naval Medical
Center San Diego, Kaiser Foundation Hospital and Seattle Children’s Hospital for their cooperation, feedback and helpful suggestions.