Surgeons operate by remote control 4,000 miles away

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The Independent Online

A French woman aged 68 has had her gall bladder removed by surgeons who were more than 4,000 miles away using a remote control in what is claimed to be the first inter- continental surgical operation.

The French surgeon and his team travelled to New York to test the effectiveness of a new system of robotics surgery that was linked to a high-speed telephone line. The patient was in Strasbourg, France. Although robot surgery over short distances has been performed, this was the first time a doctor had operated on a patient from the other side of the world, across six time zones.

Professor Jacques Mares-caux of the Institut de Re-cherche contre les Cancers de l'Appareil Digestif (Research Institute Against Cancers of the Digestive Tract) in Strasbourg, who performed the surgery, which was disclosed only yesterday, said: "It will soon be possible for the leading surgeons in their field to conduct, or take part in, an operation anywhere in the world. At present, this kind of robot costs a million dollars (£650,000) but in a few years they will be a normal part of the surgical apparatus in all hospitals." Professor Mares-caux said the operation on 7 September took 54 minutes and was a complete success with no risk to the patient, who has not been named. She was released from hospital two days after the surgery.

The woman's gall bladder was removed by keyhole surgery at the Strasbourg university hospital, using a camera and robot surgical apparatus introduced into her body through a small incision. This much is almost routine.

The difference was that the surgical team, led by Professor Marescaux, controlled and watched the movements of the miniature robot from New York. To make this possible, the time delay between the manipulation of the surgeons' hands and the movements of the robot, as monitored on a screen in the United States, had to be constant and reduced to no more than 200 milliseconds (one-fifth of a second).

France Telecom – which took part in the experiment with Computer Motion, a Californian firm specialising in medical robotics – spent two and a half years to create a high-power telephone line that reduced the delay to a minimum of 130 milliseconds and an average of 150 milliseconds, almost invisible to the naked eye. "It is this mastery of the quality and time delay of the transmission of commands over long distances which allowed us to do something never achieved before in the history of surgery," Professor Marescaux said.

The experiment – called "operation Lindbergh" after the American aviator Charles Lindbergh who was the first man to fly solo across the Atlantic – used a fibre optic line that transmitted 10 megabites of computer memory a second.

The medical team received clearance from ethics committees before the operation, and 80 people were on hand – some in New York, some in Strasbourg – in case things went wrong. Operations were conducted on animals using the same systems before the transatlantic gall bladder surgery was performed. The experiment will be described in full in the edition of the British scientific review Nature next Thursday.

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