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Medicine Idle Science

UK Surgeons Are the First To Operate In 3D 64

MrSeb writes "A team at Manchester Royal Infirmary hospital, England, claim to be the first surgeons to perform keyhole surgery using 3D cameras and monitors — and embarrassingly clunky spectacles. Furthermore, if that wasn't high-tech enough, the lead surgeon also used a hand-held robotic claw. 3D vision during surgery makes perfect sense: After all, your anatomy is three-dimensional, and when you're making minute incisions with a foot-long instrument, through an entry hole that's just an inch long, depth perception is obviously a huge boon. According to spokeswoman from the hospital, the 3D approach provides much better accuracy, 'therefore reducing the risks of muscle and nerve damage.' The same spokesperson also said that the 3D projection would reduce surgeon fatigue, presumably because trying to make sense of a 2D image for hours on end is incredibly strenuous."
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UK Surgeons Are the First To Operate In 3D

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  • by Anonymous Coward

    I don't see how this is any different from what Da Vinci [wikipedia.org] has been doing for a decade. Can somebody enlighten me as to what they did first?

    dom

    • Re: (Score:2, Informative)

      by Anonymous Coward

      First in the UK, according to the BBC [bbc.co.uk].

    • by Darinbob ( 1142669 ) on Wednesday April 04, 2012 @04:16AM (#39569377)

      Surgeries have always been 3D. A 2D surgery doesn't do much on a three dimensional patient.

      • Re: (Score:3, Funny)

        by Anonymous Coward

        3D surgeries are a step forward. When I was at the hospital, they still used four dimensions. Now, without surgeries consuming time...

        • by hawk ( 1151 )

          Due to budget cuts, we have reduced from 4d to 3d. as the other party is heartless, we may soon be down to 2D l . .

          hawk

      • by Genda ( 560240 )

        Actually 2D surgery is perfectly viable... for steamroller accident patients...

      • Surgeries have always been 3D. A 2D surgery doesn't do much on a three dimensional patient.

        True, although after my back surgery last year I was left feeling a little flat.

    • by dave420 ( 699308 )
      It's a completely different piece of kit, operated differently, which can perform completely different tasks. So apart from that, they're identical :)
    • The continuous, driving rain, the dysfunctional inhabitants and the general misery of life in Manchester probably makes the surgeons think it's still 1912. (I know, I know...Manchester has never got over the sense of entitlement it got from having the world's first stored-program practical digital computer, and having had Alan Turing as its star programmer.
    • by DrYak ( 748999 ) on Wednesday April 04, 2012 @06:32AM (#39569727) Homepage

      The Da Vinci robot is, as it names implies, a *robot*. It is remotely controlled.
      The surgeon isn't operating the patient directly, the surgeon is sitting comfortably at a console, manipulating joysticks and looking into a cinemascope-type of fixed goggle 3d display. Then in the next room, the robot is working (almost) alone (except maybe for a couple of assisting humans) remotely according to the piloting performed by the surgeon. Most of the time the patient isn't opened but the robot instruments are passed through small holes on the patient's skin.
      (It's currently in the next room, so if anything goes wrong, the surgeons can sterilize his hands and pick up the work from where the robot failed. But there has been tests performed with longer distance and a different surgeon staying in "stand by" mode)
      In this case:
      - the surgery is performed by a robot.
      - the surgeon is sitting next door, not above the patient.
      - only the surgeon gets 3D pics
      - the assitants get normal flat 2D pics on monitors in the operating room. (And during the few operation I've seen, the surgeon can use his better 3D perception and higher dexterity robot instruments to assist the assitants passing material, like stiching material).

      Laparoscopy:
      It's closed surgergy. You don't open the patient, but you manually put instruments through the skin. Also everybody (surgeon + whole crew) is in the operating room. To see what you're doing you put 1 single normal 2D camera into the body (usually using fiber optics to avoid putting the whole thing inside :-) )
      So:
      - The surgeon is operating with her/his own hands using long rigid instruments passed through the patient's skin.
      - Everybody (surgeon included) gets the same 2D picture on the screen inside the operating room.

      This case:
      2 variations from laparoscopy. They use stereoscopic pictures and robotic claws. So the "new" differences are:
      - The surgeon is still operating but her/his hands are holding hand-held robotic claws instead of simply "longer-than-classical" instruments.
      - The camera gives a 3D feed on the monitors for everyone, as long as they wear glasses.
      That's new in UK apparently (and I haven't heard about the method before)
      I don't know if you make 3 holes like classical laparoscopy (1 for the camera's fiber optics, 2 channels for passing instruments) or if you need 4 holes (2 for the camera)

      Another type of operation worth mentionning:
      Endoscopy. In this case absolutely everything is mounting on a long tentacle-shaped probe. The probe is completely articulated like a tentacle (unlike the long rigid instruments of laparoscopy, or the few joints of robotic instruments), although it doesn't move actively (it's not remotely controlled like robotic stuff, it can only bends to follow the shape of the hollow space you're following) although you *can* control the orientation of the tip (to pick up the correct turn in branching anatomy). It contains absolutely everything for the surgery packed into the tentacle: fiber optics for imaging and lights, a channel to rince and/or spray drugs, another channel to vacuum (aspiration), and a channel to pass ultra long ultra thin flexible instrument (like a small claw).
      I think most models lack the possibility to use a big electro cuterisation, but given the small claw you can't cut enough to cause massive bleedings which aren't resolved by simply spraying adrenaline.
      - Because of the small channel and small claw, it's mostly used for biopsies (taking a small chunk of something suspect to send it to the lab for analysis).
      - The claw is next to the image (at the tip of the tentacle, not a separate instrument separately operated). So you don't look while moving the instrument, instead you move the whole tentacle in position and chomp whatever is directly in front.
      - Because everything is contained into a single probe and the probe is articulated, this is mostly used to explore open orifices like the lungs (from the mouth) or the guts (from the mouth or the oppos

      • by Anonymous Coward

        OK, so according to this other article [bbc.co.uk], the Da Vinci robot has been used in the UK already, meaning that this isn't the first laparoscopic surgery in the UK in 3D. It may have the novelty of letting the rest of the team view the procedure in 3D, but that's irrelevant because only the guy manipulating the instruments needs it.

        The real difference compared to a Da Vinci is that the robotic arms are hand-held rather than held steady by a large robotic mounting. The advantage is simply that just having a couple

      • by ivec ( 61549 )

        Some additional info:

        As I commented in the original article, stereoscopic (=3D) laparoscopy has existed for more than 20 years:

        Articles such as http://www.giejournal.org/arti [giejournal.org]... show that the cost/benefit was of "3D" was being evaluated in 1992 (this study is not made "in-patient", as it was easier to measure performance in an artificial setting). The point is that stereoscopic endoscopes and display equipment were available, and I know surgeons who were trying them, but felt that the extra cost and discomfort were not worth overcoming.

        3 holes are commonly needed for a laparoscopic procedure: one for a camera, two for two instruments held by the main operator; a 4th hole is sometimes used to insert an additional instrument (allowing an assisting surgeon to lift the liver or hold an organ out of the way).
        I've seen many projects for robotized cameras (to avoid needing the additional helping hand), or projects to off

    • by mcgrew ( 92797 ) *

      From your link:

      ...The fourth arm is for an endoscopic camera with two lenses that gives the surgeon full stereoscopic vision from the console.

      The Food and Drug Administration (FDA) has cleared the da Vinci Surgical System in 2000 for adult and pediatric use in urologic surgical procedures, general laparoscopic surgical procedures, gynecologic laparoscopic surgical procedures, general non-cardiovascular thoracoscopic surgical procedures and thoracoscopically assisted cardiotomy procedures. The da Vinci Syste

  • by unreadepitaph ( 1537383 ) on Wednesday April 04, 2012 @02:39AM (#39569051)
    Google soon to provide a street view style map of my insides.
  • Prostate cancer surgery and hysterectomies is already done with robots and 3D vision. 80% of prostatectomies in the US are done with the "Da Vinci" robot in a procedure called Robot Assisted Laparascopic Prostatectomy. The surgeon operates the robot through a console with 3D vision. http://www.davinciprostatectomy.com/davinci_prostatectomy/index.aspx [davinciprostatectomy.com]
  • Mine is better, because it goes up to 11D. Across the 8th Dimension. Most only go up to 10D.

    "You can check your anatomy all you want, and even though there may be normal variation, when it comes right down to it, this far inside the head it all looks the same. No, no, no, don't tug on that. You never know what it might be attached to. "

  • Really? I am getting so sick and tired of everything being in 3D nowadays!

    -AI

    • by lxs ( 131946 ) on Wednesday April 04, 2012 @02:57AM (#39569123)

      Me too! That's why I have started wearing an eyepatch.

    • by Anonymous Coward

      Well when you go for a surgery demand the 2d surgery because you won't pay the premium for a 3d one.

    • by Idbar ( 1034346 )
      Well, according to the headline... Seems news to me the doctors just now operate in 3D. I had my suspicions that doctors may have been operating on another dimension, but they always seemed like real 3D to me. So I'm what dimension where they living all along?
  • Humans are capable of seeing 3d without technology and in fact every surgery that was done without electronics and optics have always been 3D.

    So they've figured out that using a 3d microscope is a good idea? Seriously? Weren't most of us taught this in high school or something?

    Funny how people get excited when technology finally catches up to the way we've done it all along.

    • by dave420 ( 699308 )
      Your reading comprehension is truly awful. Really, really awful. This is not a 3D microscope. This is not doing something "the way we've done it all along" - this is radically different.
    • by mcgrew ( 92797 ) *

      Dave 420 is right. If you had a gall bladder operation years ago you'd have a huge scar, was in the hospital for weeks, and it took a long time to heal. The new robotic keyhole surgeries are often done on an outpatient basis, leave tiny scars, and heal quickly.

      It's nothing like traditional surgery.

      Were you going for "funny?" If so, you failed miserably.

  • by HizookRobotics ( 1722346 ) on Wednesday April 04, 2012 @02:53AM (#39569115) Homepage
    Uhm... I'm pretty sure that every single one of the Intuitive Surgical DaVinci robot workstations are 3D for the operator -- and we all know that hundreds of surgeries are performed with these every day.. In this video of researchers playing "Operation" (the board game) with a DaVinci robot [hizook.com], you can see the operator console with separate eye pieces to give 3D effects. I personally got to play with a DaVinci at IROS (robotics conference) last year, and the operator console was definitely in 3D -- though the observer consoles are just normal 2D TVs. I was told that this had been standard for a _long_ time.
    • by dave420 ( 699308 )
      And again, as has been pointed out many times in these comments, this is radically different. I know, I know - Slashdot and not R-ing TFAs, but seriously, this is taking the piss.
      • by necro81 ( 917438 )
        OK. I have RTFA, and I still don't see how this "is taking the piss." It's endoscopic surgery, as performed hundreds of times a day in the UK. The difference is that their endoscope has a 3D camera, and the monitors are 3D. I'll admit that giving docs depth perception is an improvement, it is hardly a first. Please, tell me what is so special about this surgery, especially compared to the Da Vinci, that has half the responders to this article riding high on ecstasy.
        • by dave420 ( 699308 )
          If you read the article, and know what DaVinci is, you'd know what the differences are. It's really not hard to understand.
  • by AmiMoJo ( 196126 ) on Wednesday April 04, 2012 @03:20AM (#39569187) Homepage Journal

    From TFA:

    3D projection would reduce surgeon fatigue, presumably because trying to make sense of a 2D image for hours on end is incredibly strenuous

    I'd love to know what percentage of surgeons can see 3D images and look at them for hours without getting a headache. Personally I find 2D images much less stressful to look at.

    • by Thanshin ( 1188877 ) on Wednesday April 04, 2012 @04:22AM (#39569411)

      I'd love to know what percentage of surgeons can see 3D images and look at them for hours without getting a headache. Personally I find 2D images much less stressful to look at.

      I have so many questions...

      What does your parrot think of this?

      Is it tiring to walk with a wooden leg?

      Do you have a map with a big red X on the spot where you hid you plunder?

      What do you mean by YARRR?

    • Re: (Score:3, Interesting)

      by Anonymous Coward

      From TFA:

      3D projection would reduce surgeon fatigue, presumably because trying to make sense of a 2D image for hours on end is incredibly strenuous

      I'd love to know what percentage of surgeons can see 3D images and look at them for hours without getting a headache. Personally I find 2D images much less stressful to look at.

      It's not about that. It is about not having to reconstruct a 3d scene in your mind based on a 2d photo. You need to spend less brainpower on spatial processing trying to figure out how things are.

    • by mark-t ( 151149 )

      My first reaction to the article was along those lines as well, but then I realized that the core problem with movie "3d" is that they are trying to make a 3d image on a large screen look the same to everybody, regardless of their distance from the screen. Using stereoscopic imaging to direct different images at each eye forces people's eyes to converge towards a distance that may not necessarily correspond the distance they are actually looking at (or worse, can sometimes cause actual eye divergence if

    • by mcgrew ( 92797 ) *

      The reason "3D" movies give you headaches is because they're not really 3D. Your eye use more than stereoscopy to determine depth. Actually, the eye doesn't determine depth, the brain does. And it uses many cues from the eyes, including where your eye is focusing.

      Say you have a "3D" TV ten feet away from you. Your eyes are focused at ten feet but stereoscopy tells your brain that the butterfly is two feet from your face. That's why you get the headaches, your eyes' muscles are working against themselves.

      I d

  • Comment removed based on user account deletion
    • Probably because socialised medicine is an innovation itself.
    • by CProgrammer98 ( 240351 ) on Wednesday April 04, 2012 @04:48AM (#39569473) Homepage

      because socialised medicine actually works?. We;ve been doing it for decades in the UK. OK it's not perfect, sometimes you have to wait a while for non-urgent procedures but we're always guaranteed no matter what our social/economic standing, and the drug companies are not in cahoots with the insurance guys and hospitals to inflate the price of everything, so we don't have to pay $100 for a $0.10 pill.

    • ... as though no innovation occurs in US medical treatments and technologies under our system of private insurers. Sure (rolls eyes). If you're satisfied with your socialized medicine, bully for you. But for us in the US with the looming specter of 'Obamacare", it's odd that if it's so wonderful, why not many (and no media) are questioning why the President and all of Congress (and their dependents) will be exempt from it.
      • Comment removed based on user account deletion
      • by dave420 ( 699308 )
        You really are bad at this whole "arguing your case like an adult" thing. The mixture of hubris and ignorance is eye-wateringly awkward.
      • by mcgrew ( 92797 ) *

        Obamacare isn't socialized medicine, it's a gift to the insurance companies and doesn't help the problem at all. The problem is, we have the most expensive health care in the world but by any metric you care to measure it, it's far from the best. The insurance companies themselves are the problem. They're middlemen who siphon cash without adding any value whatever. Medical insurance companies (and their brothers, malpractice insurance) are parasites on the system.

    • by tomhath ( 637240 )
      FTA:

      It seems the surgeons were wrong in their claim — the Da Vinci surgical system, which also operates in 3D, has existed for at least 10 years. Maybe the UK surgeons are talking about a different kind of 3D

      Apparently "innovation in a country with socialized medicine" means reinventing a wheel that was approved by the FDA in the US ten years ago.

  • by Anonymous Coward on Wednesday April 04, 2012 @05:01AM (#39569509)

    I wonder if surgeons are tested for spatial perception. At least in Finland for instance architects have weeklong entrance exams, where they are tested, among other things, for their ability to think in 3d. As an architect, I am asking just out of curiosity, if this is the case also with surgeons?

    We are also using scalpels for model building...

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