<s>
Remote	B-Application
surgery	I-Application
(	O
also	O
known	O
as	O
telesurgery	B-Application
)	O
is	O
the	O
ability	O
for	O
a	O
doctor	O
to	O
perform	O
surgery	O
on	O
a	O
patient	O
even	O
though	O
they	O
are	O
not	O
physically	O
in	O
the	O
same	O
location	O
.	O
</s>
<s>
It	O
is	O
a	O
form	O
of	O
telepresence	B-Application
.	O
</s>
<s>
A	O
robot	B-Algorithm
surgical	O
system	O
generally	O
consists	O
of	O
one	O
or	O
more	O
arms	O
(	O
controlled	O
by	O
the	O
surgeon	O
)	O
,	O
a	O
master	O
controller	O
(	O
console	O
)	O
,	O
and	O
a	O
sensory	O
system	O
giving	O
feedback	O
to	O
the	O
user	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
combines	O
elements	O
of	O
robotics	O
,	O
telecommunications	O
such	O
as	O
high-speed	O
data	O
connections	O
and	O
elements	O
of	O
management	B-Application
information	I-Application
systems	I-Application
.	O
</s>
<s>
While	O
the	O
field	O
of	O
robotic	O
surgery	O
is	O
fairly	O
well	O
established	O
,	O
most	O
of	O
these	O
robots	B-Algorithm
are	O
controlled	O
by	O
surgeons	O
at	O
the	O
location	O
of	O
the	O
surgery	O
.	O
</s>
<s>
Remote	B-Application
surgery	I-Application
is	O
remote	O
work	O
for	O
surgeons	O
,	O
where	O
the	O
physical	O
distance	O
between	O
the	O
surgeon	O
and	O
the	O
patient	O
is	O
less	O
relevant	O
.	O
</s>
<s>
Surgical	O
robot	B-Algorithm
systems	O
have	O
been	O
developed	O
from	O
the	O
first	O
functional	O
telesurgery	B-Application
system-ZEUS-to	O
the	O
da	O
Vinci	O
Surgical	O
System	O
,	O
which	O
is	O
currently	O
the	O
only	O
commercially	O
available	O
surgical	O
robotic	O
system	O
.	O
</s>
<s>
Used	O
mainly	O
for	O
"	O
on-site	O
"	O
surgery	O
,	O
these	O
robots	B-Algorithm
assist	O
the	O
surgeon	O
visually	O
,	O
with	O
better	O
precision	O
and	O
less	O
invasiveness	O
to	O
patients	O
.	O
</s>
<s>
Marketed	O
for	O
$975	O
,	O
000	O
,	O
the	O
ZEUS	O
Robot	B-Algorithm
Surgical	O
System	O
was	O
less	O
expensive	O
than	O
the	O
da	O
Vinci	O
Surgical	O
System	O
,	O
which	O
cost	O
$1	O
million	O
.	O
</s>
<s>
The	O
cost	O
of	O
an	O
operation	O
through	O
telesurgery	B-Application
is	O
not	O
precise	O
but	O
must	O
pay	O
for	O
the	O
surgical	O
system	O
,	O
the	O
surgeon	O
,	O
and	O
contribute	O
to	O
paying	O
for	O
a	O
year	O
's	O
worth	O
of	O
ATM	O
technology	O
which	O
runs	O
between	O
$	O
100,000	O
-	O
$	O
200,000	O
.	O
</s>
<s>
The	O
first	O
true	O
and	O
complete	O
remote	B-Application
surgery	I-Application
was	O
conducted	O
on	O
7	O
September	O
2001	O
across	O
the	O
Atlantic	O
Ocean	O
,	O
with	O
a	O
French	O
surgeon	O
(	O
Dr.	O
Jacques	O
Marescaux	O
)	O
in	O
New	O
York	O
City	O
performing	O
a	O
cholecystectomy	O
on	O
a	O
68-year-old	O
female	O
patient	O
6,230	O
km	O
away	O
in	O
Strasbourg	O
,	O
France	O
.	O
</s>
<s>
France	O
Telecom	O
provided	O
the	O
redundant	O
fiber	B-Architecture
optic	I-Architecture
ATM	O
lines	O
to	O
minimize	O
latency	O
and	O
optimize	O
connectivity	O
,	O
and	O
Computer	O
Motion	O
provided	O
a	O
modified	O
Zeus	O
robotic	O
system	O
.	O
</s>
<s>
While	O
operation	O
Lindbergh	O
used	O
the	O
most	O
expensive	O
ATM	O
fiber	B-Architecture
optics	I-Architecture
communication	O
to	O
ensure	O
reliability	O
and	O
success	O
of	O
the	O
first	O
telesurgery	B-Application
,	O
the	O
follow	O
on	O
procedures	O
in	O
Canada	O
used	O
standard	O
public	O
internet	O
which	O
was	O
provisioned	O
with	O
QOS	O
using	O
MPLS	O
QOS-MPLS	O
.	O
</s>
<s>
Since	O
Operation	O
Lindbergh	O
,	O
remote	B-Application
surgery	I-Application
has	O
been	O
conducted	O
many	O
times	O
in	O
numerous	O
locations	O
.	O
</s>
<s>
To	O
date	O
Dr.	O
Anvari	O
,	O
a	O
laparoscopic	O
surgeon	O
in	O
Hamilton	O
,	O
Canada	O
,	O
has	O
conducted	O
numerous	O
remote	B-Application
surgeries	I-Application
on	O
patients	O
in	O
North	O
Bay	O
,	O
a	O
city	O
400	O
kilometres	O
from	O
Hamilton	O
.	O
</s>
<s>
Even	O
though	O
he	O
uses	O
a	O
VPN	B-Application
over	O
a	O
non-dedicated	O
fiberoptic	B-Architecture
connection	O
that	O
shares	O
bandwidth	O
with	O
regular	O
telecommunications	O
data	O
,	O
Dr.	O
Anvari	O
has	O
not	O
had	O
any	O
connection	O
problems	O
during	O
his	O
procedures	O
.	O
</s>
<s>
Rapid	O
development	O
of	O
technology	O
has	O
allowed	O
remote	B-Application
surgery	I-Application
rooms	O
to	O
become	O
highly	O
specialized	O
.	O
</s>
<s>
Sinai	O
Hospital	O
in	O
Toronto	O
,	O
Canada	O
,	O
the	O
surgical	O
room	O
responds	B-Application
to	I-Application
the	I-Application
surgeon	I-Application
's	I-Application
voice	I-Application
commands	I-Application
in	O
order	O
to	O
control	O
a	O
variety	O
of	O
equipment	O
at	O
the	O
surgical	O
site	O
,	O
including	O
the	O
lighting	O
in	O
the	O
operating	O
room	O
,	O
the	O
position	O
of	O
the	O
operating	O
table	O
and	O
the	O
surgical	O
tools	O
themselves	O
.	O
</s>
<s>
With	O
continuing	O
advances	O
in	O
communication	O
technologies	O
,	O
the	O
availability	O
of	O
greater	O
bandwidth	O
and	O
more	O
powerful	O
computers	O
,	O
the	O
ease	O
and	O
cost-effectiveness	O
of	O
deploying	O
remote	B-Application
surgery	I-Application
units	O
is	O
likely	O
to	O
increase	O
rapidly	O
.	O
</s>
<s>
The	O
armed	O
forces	O
have	O
an	O
obvious	O
interest	O
since	O
the	O
combination	O
of	O
telepresence	B-Application
,	O
teleoperation	O
,	O
and	O
telerobotics	O
can	O
potentially	O
save	O
the	O
lives	O
of	O
battle	O
casualties	O
by	O
providing	O
them	O
with	O
prompt	O
attention	O
in	O
mobile	O
operating	O
theatres	O
.	O
</s>
<s>
Another	O
potential	O
advantage	O
of	O
having	O
robots	B-Algorithm
perform	O
surgeries	O
is	O
accuracy	O
.	O
</s>
<s>
A	O
study	O
conducted	O
at	O
Guy	O
's	O
Hospital	O
in	O
London	O
,	O
England	O
compared	O
the	O
success	O
of	O
kidney	O
surgeries	O
in	O
304	O
dummy	O
patients	O
conducted	O
traditionally	O
as	O
well	O
as	O
remotely	O
and	O
found	O
that	O
those	O
conducted	O
using	O
robots	B-Algorithm
were	O
more	O
successful	O
in	O
accurately	O
targeting	O
kidney	O
stones	O
.	O
</s>
<s>
Roger	O
Smith	O
,	O
CTO	O
at	O
the	O
Florida	O
Hospital	O
Nicholson	O
Center	O
said	O
that	O
the	O
team	O
had	O
concluded	O
that	O
,	O
telesurgery	B-Application
is	O
something	O
that	O
is	O
possible	O
and	O
generally	O
safe	O
for	O
large	O
areas	O
within	O
the	O
United	O
States	O
.	O
</s>
<s>
As	O
the	O
techniques	O
of	O
expert	O
surgeons	O
are	O
studied	O
and	O
stored	O
in	O
special	O
computer	O
systems	O
,	O
robots	B-Algorithm
might	O
one	O
day	O
be	O
able	O
to	O
perform	O
surgeries	O
with	O
little	O
or	O
no	O
human	O
input	O
.	O
</s>
<s>
Systems	O
known	O
as	O
force-feedback	O
,	O
or	O
haptic	B-Device
technology	I-Device
,	O
have	O
been	O
developed	O
to	O
simulate	O
this	O
.	O
</s>
<s>
Haptic	B-Device
technology	I-Device
in	O
telesurgery	B-Application
,	O
making	O
a	O
virtual	O
image	O
of	O
a	O
patient	O
or	O
incision	O
,	O
would	O
allow	O
a	O
surgeon	O
to	O
see	O
what	O
they	O
are	O
working	O
on	O
as	O
well	O
as	O
feel	O
it	O
.	O
</s>
<s>
However	O
these	O
systems	O
are	O
very	O
sensitive	O
to	O
time-delays	O
such	O
as	O
those	O
present	O
in	O
the	O
networks	O
used	O
in	O
remote	B-Application
surgery	I-Application
.	O
</s>
<s>
Humans	O
 '	O
binocular	B-Algorithm
vision	I-Algorithm
makes	O
this	O
easy	O
in	O
a	O
three-dimensional	O
environment	O
.	O
</s>
<s>
One	O
possible	O
use	O
of	O
remote	B-Application
surgery	I-Application
is	O
the	O
Trauma-Pod	O
project	O
conceived	O
by	O
the	O
US	O
military	O
under	O
the	O
Defense	O
Advanced	O
Research	O
Agency	O
.	O
</s>
<s>
Another	O
future	O
possibility	O
could	O
be	O
the	O
use	O
of	O
remote	B-Application
surgery	I-Application
during	O
long	O
space	O
exploration	O
missions	O
.	O
</s>
<s>
For	O
now	O
,	O
remote	B-Application
surgery	I-Application
is	O
not	O
a	O
widespread	O
technology	O
in	O
part	O
because	O
it	O
does	O
not	O
have	O
sponsorship	O
by	O
the	O
governments	O
.	O
</s>
<s>
Also	O
,	O
there	O
is	O
still	O
the	O
need	O
for	O
an	O
anesthesiologist	O
and	O
a	O
backup	O
surgeon	O
to	O
be	O
present	O
in	O
case	O
there	O
is	O
a	O
disruption	O
of	O
communications	O
or	O
a	O
malfunction	O
in	O
the	O
robot	B-Algorithm
.	O
</s>
