Cedars-Sinai Medical Center Sets the Stage for "Operating Room of the Future"
Library: MED
Keywords: ROBOTIC SURGERY ROBOTIC EQUIPMENT INTEGRATION VOICE-ACTIVATED CONTROL SYSTEM
Description: When Zeus joins the surgical team in September, Cedars-Sinai Medical Center will move another step closer to creating the "operating room of the future." Zeus is the hospital's newest, most evolved generation of robot, and will play a pivotal role in the high-tech surgical environment under development at Cedars-Sinai. The medical center introduced robotics about a year ago in its first modernized OR suite.



Media Contact: Sandra Van
E-mail: sandy@vancommunications.com
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LOS ANGELES, CA (June 17, 2002) -- When Zeus joins the surgical team in September, Cedars-Sinai Medical Center will move another step closer to creating the "operating room of the future." Zeus is the hospital's newest, most evolved generation of robot, and will play a pivotal role in the high-tech surgical environment under development at Cedars-Sinai.

The medical center introduced robotics about a year ago in its first modernized OR suite, primarily used for spine procedures. The second redesigned room, which will house Zeus, will be utilized for an array of surgical cases performed by general surgeons, urologists, cardiologists and pediatric surgeons.

The "modern" OR has several unique features, according to Achilles Demetriou, M.D., Ph.D., Chairman, Department of Surgery. Among them: robotic equipment integration, a voice-activated control system, computer access to patient data, Internet connectivity, enhanced video capabilities, and a streamlined distribution system for supplies and equipment.

"These elements are not new by themselves," explains Dr. Demetriou, who spearheads the project, " It's the integration that's new. More and more facilities are moving to these types of integrated, technically advanced operating rooms."

And for good reason. Not only does this reinvented operating room increase efficiency and economy, it also expands the opportunities for minimally invasive surgical procedures, offering patients more and better treatment options.

"We can integrate the robot into minimally invasive surgery, since it's so versatile and is linked to the integrated technology in the OR," adds Dr. Demetriou.

The original three robots, called Aesops, have a simple, single mechanized arm. Zeus is multi-armed and much more advanced, and is currently being used in a lab setting for physician training. "These robots look like a piece of machinery," Dr. Demetriou points out, quickly dismissing any misconception of their "human qualities." They have retracting arms with two or three jointed segments. The benefits are that the robots can repeat motions with great precision and with no fatigue. The robot is stationed at the surgeon's side--we are not interested in any remote-controlled application."

Dr. Demetriou also emphasizes that "this equipment doesn't replace humans but, instead, replaces certain functions that are better done by a machine." This allows trained staff to better utilize their skills in the OR setting.

And this setting is dramatically changed in the "modern" OR. Gone are the clutter of floor carts and tangle of wires and hoses--the new operating suites boast uncluttered floorspace with equipment supported on ceiling booms or stored in cabinets.

"The system is much more flexible," says Phillip Bonwell, service line manager, OR, Surgery and Anesthesia Center. "Non-essential components are out of way, making the room easier to maneuver and clean. Glass cabinets contain equipment, and there are no cables or gas lines on the floor, making for a safer environment."

The "video stack," which includes cameras, controls, lights, VCR and printer, are now either cabled to booms or stored in glass cabinets, and are now remote controlled. Multiple video monitors, mounted on booms, allow better visuals of the field and surgical site. "These high-resolution, flat-panel monitors can be suspended at various positions around the room--at the foot of the bed, above the surgeon's shoulder, wherever," says Jan Decker, R.N., service line manager, OR, Surgery and Anesthesia Center.

Adds Bonwell: "Before, only the surgeon and someone directly by his or her side could view the monitor, but now everyone in the OR who needs to visualize the scene can, including the operating physician, scrub nurse or technician." These images can also be transferred to external locations for viewing or training purposes, or even transmitted via computer for tele-consultation.

"The surgeon is at the command post, like a pilot," explains Dr. Demetriou. "The controls are voice activated to dim lights, change positions, whatever. The doctor has his own prerecorded card imprinted with his own voice commands, so the voice recognition system is individualized for each surgeon."

With the robotic arm integration, the physician can voice command: "Arm one, move right. Move left. Relax." Also at the physician's fingertips is computer access to the hospital information system, allowing patient data to be accessed right in the OR. The surgeon can upload X-rays and CT or MRI scans for reference, and even log onto the Internet to consult with another physician.

The redesign of the room also provides more cabinetry for storage, so nurses can easily access supplies on site, says Decker. "The staff loves it--it's easy to move around the room and all the equipment and supplies are right there."

The goal now is to bring more operating rooms on line. "We eventually want to rebuild all the OR rooms, since the same attributes could be applied to any kind of surgery," states Bonwell.

"It's a lot of fun," acknowledges Dr. Demetriou of exploring and creating this new high-tech surgical environment. "Cedars-Sinai is totally committed to this as a research project, documenting where it works and where it doesn't, and determining new applications."

Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For the fifth straight two-year period, Cedars-Sinai has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthrough biomedical research and superlative medical education. Named one of the 100 "Most Wired" hospitals in health care in 2001, the Medical Center ranks among the top 10 non-university hospitals in the nation for its research activities.

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