printable versionNext-generation Internet service might include surgery
Upgrades to networks could let physicians operate by remote control on patients across the country
BY ROSANNE SPECTOR
FCC commissioner Michael Copps donned 3-D glasses so he could participate in an online surgery demonstration. Stanford’s LeRoy Heinrichs (left) offered tips, though the lead instructor was in Australia.
Why were faculty members helping a Capitol Hill bureaucrat to do gallbladder surgery?
It makes sense when you realize that the public servant was Michael Copps, a commissioner at the Federal Communications Commission, and the surgery was a demonstration on a virtual patient, not a real one, using a new Internet technology.
The demo took place June 6 at the Washington, D.C., office of Internet2, the non-profit consortium that develops advanced network applications and technologies. The group created and maintains the ultimate information superhighway, which is used at 206 universities. The high-speed system can transfer wide loads of data that would jam traffic lanes on the standard Internet. The name for the backbone of the network is Abilene, but it is commonly called Internet2.
The point of Stanford's demo, one of two during the meeting with Copps, was to expose an influential telecommunications policymaker to extra-wide bandwidth networking and its potential for education and health care. It's part of a larger effort to sway policymakers to raise standards for federally regulated communication networks.
The FCC is preparing an update of the Telecommunications Act of 1996, which is expected to include specifications for commercial networks. The government's current proposal calls for bandwidth of 1 to 2 megabytes per second, which falls short of the mark for the applications that researchers at Stanford and elsewhere are exploring. "We need to have 100 megabytes per second or even gigabytes for these applications to run," said Stanford virtual surgery expert Sakti Srivastava, MD.
In the first demonstration, Copps and staffers met a diver exploring the Monterey Bay. The network allowed the group in D.C. to guide the underwater camera and to have conversations with the diver, who they could see swimming across the computer screen in real time.
Next on the agenda was the virtual anatomy lesson and gallbladder surgery, both conducted over the Internet with instructors thousands of miles away.
At Copps' side in D.C. was LeRoy Heinrichs, MD, PhD, a retired Stanford gynecology professor who has made a second career developing high-tech medical educational products. On hand to explain the technology behind the demo and to pass around the required 3-D glasses was Robert Cheng, who like Heinrichs works at SUMMIT, or Stanford University Medical Media and Information Technologies.
Meanwhile, SUMMIT's director, Parvati Dev, PhD, and Srivastava, SUMMIT's director of anatomy and surgery applications, joined the gathering by teleconference from an office at Stanford. The SUMMIT team members are world experts in online medical education. Among their projects is a National Library of Medicine-funded effort to develop online collaborative techniques for surgery and anatomy training. The group has run dozens of such cross-continental sessions over the last few years.
The group first gave Copps an anatomy lesson on the hand, taught by hand surgeon Srivastava. As a 3-D hand appeared on the screen before Copps, Srivastava, sitting in a chair at Stanford, maneuvered a blue arrow to point out areas of interest. Srivastava and Copps moved the hand so they could see it from different angles, switching between views of skin and muscle.
The next demo took distance learning one step further, allowing virtual surgery expert Chris Gunn, who was in Canberra, Australia, to guide Copps' hand to feel and manipulate a simulated gallbladder, liver and bile duct.
Copps held a control stick, which was tethered to a computer. Gunn, a scientist at Australia's Commonwealth Scientific and Industrial Research Organisation, felt Copps' moves through a similar stick at his end.
"Take a hold of that gallbladder," Gunn instructed Copps. "Did you feel that pull back?"
Copps said he could. "I've removed a gallbladder," he remarked upon finishing. "That was outstanding. I'm going to tell my kids about what I did today."
Back at Stanford, the SUMMIT team has another demonstration up and running: an Internet-based television channel offering hour-long interactive cadaver-based anatomy lessons. For more information, please contact Srivastava, the project's leader, by e-mail at sakti.srivastava@stanford.edu.