|updated March 5, 2011|
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From Space To Surgery:
The McMaster Centre for Medical Robotics
Pushing the frontiers of technological innovation is synonymous with space exploration, an area where Canada has established itself as a world leader in space robotics. The long, articulated robotic arms on the Space Shuttle and International Space Station, affectionately know as the Canadarm and Canadarm II, have played a critical role in assembling the largest, most complex, orbiting aboratory in history. The addition of the Canadian Dextre robot, has provided a new level of precision to space robotics that will be critically important in servicing the many complex instruments onboard the International Space Station.
Robotics has enabled many seemingly impossible feats in space exploration and the recent application of this technology to the development of surgical robots is having a similar role changing the future of surgical care. MacDonald Dettwiler and Associates (MDA) has leveraged the investment in Canadian space robotics by producing the second generation of surgical robots. In partnership with Dr. Garnette Sutherland at the University of Calgary, a unique neuro-surgical robot was developed that can be used with intra-operative MRI image guidance. Based upon the design used to create the Dextre robot for space, MDA engineers were able to create this specialized surgical robot to enhance the precision of surgeons performing delicate operations on the brain. Now, in collaboration with clinical researchers at St. Josephʼs Healthcare Hamilton and McMaster University the MDA team has joined forces with engineers at McMaster University to develop the next generation of this exciting technology.
Changing Surgical Care
Conversion - this word represents one of the many impacts these new technologies will have in patient care. Innovative robotic devices enable the conversion of surgical procedures that require large incisions into minimally invasive procedures using “keyhole” incisions. Patients will benefit from shorter hospital admissions, less pain and faster recoveries. Ultimately, it may be possible to convert some procedures that currently require hospital admission into outpatient procedures. Continued research to develop innovative surgical technology will produce new robotically controlled instruments that can convert “keyhole” incisions in the abdominal wall to scarless surgery using instruments introduced through natural body orifices to operate from within the body.
“I measure what I do in my career based upon my ability to affect positive change. Working with the scientists, physicians and engineers at one of Canada’s foremost research universities in collaboration with other institutions will produce technologies that will change the future of surgical care.” Dr. Dave Williams
The integration of pre-operative diagnostic images and intra-operative imagery into advanced robotic control systems is an important step in the evolution of surgical robotic technology. Building on the image guidance capability of NeuroArm, the next generation of surgical robots will have fully integrated image guidance to provide surgeons with tools to target specific sites of disease within the body.
Controlling robots from a distant location is another exciting aspect of the application of space robotics to surgery. A fundamental aspect of the design of space robots is the ability to control the robot remotely from mission control on Earth. Referred to as teleoperation, this capability can be extended to surgical robotics enabling surgeons to perform complex operative procedures on patients located in communities thousands of kilometers away. While still in the research stage, the application of this technology to surgery may help overcome the geographic disparity of health care services and improve accessibility to sophisticated surgical care in smaller Canadian communities. Telerobotic technology can bring state-of-the-art academic surgery to treat patients in their own community. It can also be used to provide advanced clinical training to community physicians with tele-mentoring instruction from specialized academic colleagues.
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Space and Remote Care Medicine:
Healthcare at the Frontier of Exploration
The McMaster Centre for Medical Robotics was envisioned as a way to integrate the research of clinicians, engineers and other health researchers into multidisciplinary teams to produce innovative technologies. Bringing these new technologies to market through commercialization initiatives will expand Canadian leadership in the rapidly growing global biomedical technology sector.
These technologies are also directly applicable to the goal of the McMaster Centre for Space and Remote Care Medicine. This new initiative was created to coordinate research to enhance the delivery of sophisticated medical care in isolated, extreme environments. In collaboration with the Canadian Space Agency (CSA), NASA, other government and academic partners, investigators at McMaster University participate in remote medical care research at space analogue sites in the arctic and the ocean.
Whether it is using the Deep Worker 2000 submersible at the CSA research analogue site at Pavilion Lake British Columbia, to study unique geological structures created by bacteria called microbialites (upper left), or working on the Aquarius undersea research habitat (upper right) to evaluate tele - health technologies through participation in the the NASA extreme environment analogue research program, the research and teaching interests of Dr. Williams typify those of the next generation of field scientists. Their interest in fundamental science, space exploration research and behavioral studies is of vital importance to understand how to support humans working in these extreme harsh environments.
Inspiring the Next Generation:
Pushing the Envelope
Undersea and space exploration provide excellent opportunities to study the many changes in human physiology associated with living and working in these two final frontiers. The acclimation to microgravity associated with long duration missions on the International Space Station provide important opportunities to study the complex multi-system physiologic changes associated with space exploration.
The McMaster University Faculty of Health Sciences now offers multi-disciplinary, collaborative courses ranging from Space Physiology and Medicine to Life on Mars that complement the academic focus of the McMaster Origins Institute. Created in 2004, the Institute is dedicated to understanding the origins of the cosmos, the elements, the space-time continuum as well as the origins and diversity of life, species and humanity. Bringing together faculty from different scientific disciplines and academic institutions, has created an environment in which students can now study all aspects of space life science ranging from astrobiology to advanced space physiology and medicine. The problem based format utilized for these courses fosters a creative environment that stimulates participants to identify new technologies to push the envelope of human space exploration.
The types of physiologic changes that occur in the space environment, or on return to Earth, include; muscle wasting, osteoporosis, cardiovascular de-conditioning and lightheadedness, dizziness and vertigo associated with neuro-vestibular acclimation in addition to changes in immune function and the effects of radiation exposure. The goal of leaving low earth orbit to have humans return to the Moon by the 50th anniversary of Apollo, is very exciting and underlies the need for the next phase of exploration enabling space life science research to mitigate these risks. The creation of collaborative research networks between Canadian universities, the private sector, government organizations and international partners will play a critical role ensuring Canadian scientists remain at the forefront of this field of research. Missions to search for evidence of life elsewhere in our solar system will combine human exploration with robotic capability in pursuit of the answer to the timeless question: Does life exist only on Earth?
The application of new knowledge and technologies arising from space research to medicine has, and continues to play, an important role in developing innovative approaches to current issues in healthcare. The terrestrial application of space technology has resulted in many important advances in healthcare that are changing medical practice. In addition to surgical robotics, space research has led to the development of digital breast biopsy systems, laser angioplasty, implantable ventricular assist devices and programmable pacemakers. Collaborative, multi-disciplinary research is a fundamental aspect of the development of many space technologies that has led to breakthroughs in the research and development of new technologies. Utilizing a similar approach to undergraduate and postgraduate programs in the space sciences, will foster the type of innovative research required to create new technologies that will enable human return to the Moon and ultimately, human missions to Mars. Todayʼs students will become tomorrowʼs researchers and will make such seemingly impossible goals, possible.
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