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Florida Hospital Nicholson Center Changes How Robotic Surgery Is Learned

CELEBRATION, Fla. June 10, 2014 – Florida Hospital Nicholson Center’s research into remote surgery or telesurgery began with two questions: “Can it be done?” and “Is it safe?”  After the research was completed, funded with a $4.2 million grant from the Department of Defense (DoD), the answer to both questions is…yes.

For the past three years, Roger Smith, Chief Technology Officer at the Florida Hospital Nicholson Center, has asked physicians to try their hand at telesurgery using a robotic surgery simulator developed by Mimic Technologies Inc.  In a telesurgery environment, there would be a communications delay between a surgeon sitting in one location performing an operation and the patient in another location across the city, state, or country.  The goal was to determine how this delay would impact the surgeons during an operation.  Smith’s question: how long of a delay is safe?  The research determined that 200 milliseconds delay (almost the speed of a blink) was imperceptible to surgeons and that most surgeons could compensate for delays up to 500 milliseconds (half a second). 

The next task: Can communications between two metropolitan hospitals be conducted within that 200 millisecond window?  Again, Smith and the Nicholson Center team said yes.  They conducted experiments using the existing connectivity between Florida Hospital locations in Central Florida and found there was on a 5 millisecond delay between hospitals; well within the 200 millisecond threshold needed to operate safely.  Additional tests from Celebration Health to Daytona Beach, Tampa, even Fort Worth, TX came back with safe levels of delay between 10 and 150 milliseconds.  Next the team will look to repeat their connectivity tests to Denver, CO and Loma Linda, CA. 

“These results indicate that modern, well connected facilities possess the communication bandwidth needed to safely perform telesurgery today. It appears that we have the technology, but are still waiting for business cases and regulatory permissions to open the door for telesurgery.” Smith said. 

In addition to the telesurgery experiments, the Nicholson Center grant from the DoD funded the creation of the world’s first standardized robotic surgery curriculum, called the Fundamentals of Robotic Surgery.  Until now, there was no set standard of learning materials and tests that could measure whether a surgeon was prepared to operate on a patient using a daVinci robot. 

The Nicholson Center team gathered 30 robotic surgery experts from around the world, representing 17 different medical societies to create a curriculum that covered all of the essential skills necessary to be a proficient robotic surgeon. 

After three years of collaboration, this curriculum has been published and hospitals world-wide are already using it train physicians new to robotic surgery. 

"The Florida Hospital Nicholson Center is taking a leadership role in a revolutionary new robotic surgery curriculum,” said Dr. Richard Satava, Professor Emeritus of Surgery at University of Washington and prominent international medical consultant.  “Their participation in this scholarly course is a major contribution to the quality of healthcare and improving patient safety on a national and global scale."

The Department of Defense has chosen to extend the Nicholson Center’s funding so work can continue to be done to advance the frontiers of robotic surgery.

For more information, contact Florida Hospital Media Relations at 407-303-8217.

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