1. The Operating Room of the Future
Richard M. Satava, MD FACS
Professor of Surgery
University of Washington School of Medicine
and
Program Manager, Advanced Biomedical Technologies
Defense Advanced Research Projects Agency (DARPA)
Special Assistant, Advance Medical Technologies
US Army Medical Research and Materiel Command
Medicine Meets Virtual Reality MMVR - 12
Newport Beach, CA
January 15, 2004
September , 2003

2. Operating Room of the Future
An Operating Room without people
September , 2003

3. Problem
Operating room is not integrated and uses industrial age tools which do not meet the needs of advanced technologies
The OR size is huge, personnel are many, management is fractured, tempo slow, supply & inventory requirements redundant and real-time quality assurance non-existant.
September , 2003

4. Result
An operating room which is dirty maladapted, slow, inefficient, kluged without quality improvement and not cost effective.
September , 2003

5. What technology is available today off the shelf that we can
Current Technology
What technology is available
today off the shelf that we can
adapt to the OR of the Future?
And LSTAT is already filling these gaps, providing continuous monitoring and therapy throughout the pre-op, intra-op, and post-op phases of nearly 30 surgeries to date, as well as recent deployment by the U.S. Army into Kosovo.
These surgeries have exploited LSTAT’s suite of integrated state-of-the-art devices including
defibrillator, ventilator, suction, monitoring, drug infusion, and blood chemistry analysis
all supported by on-board batteries and on-board oxygen to provide “stand-alone” capability during transport phases
all connected to an on-board data storage and transmission capability, including patient monitoring in real time from anywhere in the hospital…or anywhere in the world over secure websites on the World Wide Web
September , 2003

6. The LSTAT Defibrillator Ventilator Suction Monitoring
Blood Chemistry Analysis
3-Channel Fluid/Drug Infusion
Data Storage and Transmission
On-board Battery
On-board Oxygen
Accepts Off-Board Power and Oxygen
And LSTAT is already filling these gaps, providing continuous monitoring and therapy throughout the pre-op, intra-op, and post-op phases of nearly 30 surgeries to date, as well as recent deployment by the U.S. Army into Kosovo.
These surgeries have exploited LSTAT’s suite of integrated state-of-the-art devices including
defibrillator, ventilator, suction, monitoring, drug infusion, and blood chemistry analysis
all supported by on-board batteries and on-board oxygen to provide “stand-alone” capability during transport phases
all connected to an on-board data storage and transmission capability, including patient monitoring in real time from anywhere in the hospital…or anywhere in the world over secure websites on the World Wide Web
September , 2003
Courtesy of Integrated Medical Systems, Signal Hill, CA

7. LSTAT Deployment – Air, Land and Sea
LSTAT Deployed at Operation Brightstar
LSTAT Deployed on Naval ship Tarawa
September , 2003
Courtesy of Integrated Medical Systems, Signal Hill, CA

8. LSTAT Deployment to Kosovo
212th MASH Deployed with LSTAT - Combat Support Hospital
September , 2003
Courtesy of Integrated Medical Systems, Signal Hill, CA

9. LSTAT in Battlefield Configuration
Courtesy Matt Hanson, Integrated Medical Systems, Signal Hill, CA
September , 2003

10. Next Generation LSTAT – Civilian version Courtesy Integrated Medial Systems, Signal Hill, CA
September , 2003

11. We can adapt from industry…
Clean room technology and standards
(today’s OR cannot even meet Class 10,000 standards)
Implement “robotic cell” methods
(integrate collaborative robots - below)
Replace humans interacting with robots (scrub, etc)
(tool changer for scrub, parts dispenser for circulator)
Miniaturize for mobility and efficiency
Just-in-time billing, supply and inventory
(do in millisecs with +100% efficiency what takes hours today)
September , 2003

12. We can adapt from industry…
Pre-operative planning and surgical rehearsal
(rehearse [edit] individual patient for “perfect” procedure)
Provide continuous monitoring for performance improve
(record/store hand/robot motions to analyze surgical procedure)
Integrated training through patient-specific simulation
(embedded training – “train as you fight, fight as you train”)
Record procedure for privileges and credentials
(eliminate cramming for periodic examinations)
Become autonomous, single soldier (SurgiPod)
(remove surgeons and medics from the battlefield)
September , 2003

13. Why robotics and imaging
A robot is not a machine . . .
it is an information system with arms . . .
A CT scanner is not an imaging system
it is an information system with eyes . . .
etc
An operating room is an information system with . . .
September , 2003

14. A scenario Preop holding with smart table
and anesthesia (suspended animation)
Total body scan on smart table
Pre-operative “asepsis”
(not part of this phase - ? SLIME)
Entry-docking of table to robot
Surgeon plans/rehearses
Procedure while waiting for patient
September , 2003

15. A scenario (continued)
Edit procedure and operate in minutes
(Surgical prototyping)
Robot cell with tool changer
and supply dispenser
Automatic billing, re-ordering
Continuously monitor assess
(error reduction, proficiency credentials,etc)
Miniature, self-contained, autonomous
(mobile, robotic systems on battlefield of FCS)
September , 2003

16. The Challenge Make smart table CT compatible “Sterlization” procedure
Integrate robotic “cell”
Realtime data acquisition of tools/supplies
Integrate pre-op simulation, rehearsal, editing and exporting
September , 2003