Johns Hopkins University Launches Research Center To Expand Role Of Computers, Robots In Surgery

BALTIMORE--Picture the operating room of the future: Before asingle incision is made, the surgeon uses a customizedcomputer-generated model of the patient to help diagnose thecondition needing treatment, to evaluate treatment options andto rehearse a personalized surgical plan.

When the real operation begins, a computer combines thisinformation with three-dimensional medical images and displaysthe surgical plan, overlaid on the patient. Robotic devicesaugment the surgeon's own hand-eye coordination to help carryout the procedure exactly as planned.

With this electronic help, the surgery could be safer and moreprecise, yet less costly. And the patient would recover morequickly.

To help realize this goal, the National Science Foundation thismonth began a $12.9-million five-year cooperative agreement withThe Johns Hopkins University to establish an EngineeringResearch Center in Computer-Integrated Surgical Systems andTechnology.

Russell H. Taylor, a Johns Hopkins University computerscientist, will serve as director of the nation's first researchcenter set up to create computer-linked surgical systems andmedical robots. By combining highly advanced informationtechnology with surgical expertise, Taylor believes, the centerwill usher in dramatic changes in medical care.

His vision is shared by other prominent researchers at Hopkinsand its partner institutions. James H. Anderson, a professor ofradiology at the Johns Hopkins School of Medicine, will serve asdeputy director of the new research center. Takeo Kanade ofCarnegie Mellon University and Eric L. Grimson of MIT will beassociate directors.

"Computer-integrated surgical systems and technology will havethe same effect on health care in the next 20 years thatcomputer-integrated manufacturing had on industrial productionover the past 20 years and for many of the same reasons," Taylorsaid. "By integrating information with action, these systemswill lead to critical advances both in the quality of surgicaltreatment and in its cost-effectiveness."

Johns Hopkins engineering researchers will join with Hopkins'School of Medicine, its Applied Physics Laboratory, MIT, Brighamand Women's Hospital, Carnegie Mellon and Shadyside Hospital tofulfill this vision. The universities and hospitals involvedwill contribute another $8.1 million over the first five years.Industry donors have pledged $1.75 million in additional fundsfor the first year alone. During the program's first five years,almost $9 million in industry funding is anticipated.

NSF funding for this research center is renewable for anadditional five years. The program is expected to be financiallyself-sustaining after 10 years.

Engineering Research Centers focus interdisciplinary teams offaculty and students on research to produce next-generationtechnology and education. Through close collaboration withindustry and other practitioners, they speed technology transferand develop a new generation of engineers and scientists who aremore effective in industry and practice. This ERC joins a groupof 20 others that involve more than 500 firms in a wide range offields, including bioengineering, multimedia technology, andmanufacturing.

In Baltimore, the research center will be set up in new andrenovated space at Hopkins' Homewood and medical campuses. Itwill draw upon experts in computer science and electrical,mechanical and biomedical engineering, as well as physiciansspecializing in fields such as radiology, neurosurgery, urology,orthopedics, ophthalmology and many other surgical disciplines.

The Carnegie Mellon team -- led by Kanade, director of thatuniversity's robotics institute -- will focus on the developmentand applications of computer vision, sensors and robotic devicesfor computer-assisted surgery. The researchers will collaboratewith Shadyside Hospital.

MIT will contribute computer models to plan and guide thesurgery. "We take medical scans of a patient and use them tocreate a graphical reconstruction of the patient's internalanatomy," said Grimson, MIT's principal investigator for thecenter and a professor in the Department of ElectricalEngineering and Computer Science. A prototype of this system hasbeen in almost daily use at Brigham and Women's Hospital, MIT'scollaborator, since 1997.

Johns Hopkins president William R. Brody said, "This EngineeringResearch Center is a prime example of how collaborative,multi-disciplinary teamwork and cutting-edge technology --directed at real, practical problems -- will help shape thedirection of both research and education within the universitysystem of the 21st century. This technology promises to changethe way health care is delivered throughout the world,benefitting both physicians and their patients."

Ilene Busch-Vishniac, Hopkins' dean of the Whiting School ofEngineering, said, "This Engineering Research Center will buildon a number of very strong imaging and robotics programs atHopkins. Coupled with our strong collaboration with MIT,Carnegie Mellon and our schools' affiliated hospitals, thiscenter is well-positioned to make major contributions tocomputer-assisted surgery."

Dr. Lynn Preston, ERC program leader at the NSF, added, "ThisERC is an excellent example of how a team of researchers,medical practitioners and their industrial partners need acenter to achieve their ambitious goals. Their vision ofcombining capability in robotics, computer modeling and imaging,and human-computer interfaces with surgery is nearly impossiblein the traditional, disciplinary construct of a university. Thecenter format enables collaboration across these disciplinaryperspectives and sets ambitious technological goals inpartnership with both industry and surgeons. Our review panelsfound this ERC to be very exciting and were optimistic about itspotential to have a positive impact on health care." High-techtools for the operating room

The center's director, Taylor, is a professor of computerscience and an internationally recognized expert in medicalrobotics and computer-assisted surgery, who moved to JohnsHopkins from IBM Research in 1995. He emphasized that these newtools will augment the skills of highly trained surgeons, notreplace the physicians.

Human surgeons, he pointed out, far surpass machines inadaptability and, most importantly, judgment. But human handsneed a large opening in which to work. They sometimes experiencetremors and fatigue and may have difficulty manipulating verysmall objects. Also, humans can be harmed by the radiation usedin some medical treatments.

A mechanical "hand," skillfully directed by a surgeon, couldovercome these drawbacks. "You could transcend human limitationsin the execution of surgical tasks," said Taylor.

Before a scalpel even touches the patient, he said, a surgeoncould use advanced imaging and modeling equipment to plan theoperation on a computer screen. "Then, in the operating room,"Taylor said, "by using real-time imaging and real-time sensors,we will be able to match the virtual reality of this plan withthe actual reality of the surgery."

He added: "These systems will let you do things you could neverdo any other way. Also, they promote much greater consistency insurgical execution, fewer errors and fewer complications.Finally, the systems potentially allow you to record more dataabout what you intend to do, and what you actually did insurgery, so that you can learn from your work and improve it."

Private industry will play a key role, providing research fundsand helping to test and incorporate the new systems into modernoperating rooms. Finally, the center will have a strongeducational component, training a new generation of engineersand physicians who will develop and use the new high-techmedical tools.

Taylor cautions that before such medical computers and surgicalrobots can be used on patients, many basic science andengineering problems must be solved. These include improvementsin imaging and anatomical modeling techniques, sensors andhuman-computer interfaces. These advances must be combined intosystems and undergo rigorous testing in realistic settings,Taylor said. He added that industry engineers, surgeons,university researchers and students must work closely to speedprogress.

"You need a venue to make these things happen," Taylor said."That's what NSF Engineering Research Centers are all about."

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Color slides available, showing Russell Taylor and JamesAnderson with robotic surgery tools. Contact Phil Sneiderman

Related Web Sites:

Russell Taylor's Computer Integrated Surgery Lab:http://www.cs.jhu.edu/labs/cis/about.html

Robotics Research at Johns Hopkins University:http://robotics.me.jhu.edu/#labs

NSF Engineering Research Centers:http://www.eng.nsf.gov/eec/erc.htm

Medical Robotics and Computer-Assisted Surgery at CarnegieMellon and Shadyside Hospital: http://www.mrcas.ri.cmu.edu

MIT's Project on Image Guided Surgery:http://www.ai.mit.edu/projects/vision-surgery/surgery_home_page.html

News Contacts at partner institutions:

Carnegie Mellon University: Contact Anne Watzman, (412)268-3830; e-mail: aw16@andrew.cmu.edu

MIT: Contact Elizabeth Thomson, (617) 258-5402; e-mail:thomson@mit.edu