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DEMONSTRATION OF
SURGICAL TELEROBOTICS AND VIRTUAL TELEPRESENCE
BY INTERNET+ISDN
MONTEREY (USA) TO MILAN (ITALY)
Prof. Eng. Alberto Rovetta, Eng. Remo Sala, Eng. Mirco Bressanelli, Eng. Flavio Lorini,
Arch. Rita Pegoraro, Arch. MariaRita Canina, Ms. Maria Elena Garavaldi

5
Monterey, California


Abstract

This paper deals with the connection which has been held on 8th July 1997 in collaboration with the JPL of the NASA, Pasadena, California, between the Eighth International Conference on the Advanced Robotics (ICAR ‘97) in course at Monterey, California and the Telerobotics Laboratory of Politecnico di Milano connected in a multipoint teleconference through the MCU of Rome with the Aula Magna of the same Politecnico and the Palace Business of the Giureconsulti of the Chamber of Commerce of Milan. The demonstration has allowed to telecontrol a scara robot of the Sankyo and an ABB robot, which have affected simulations of operations of biopsy to the prostate, to the liver and to the breast, a mechanical hand and a model of a car, disposed in a space destined to reproduce the Martian ground, from Monterey to Milan by means of the INTERNET+ISDN connection form. In fact the event has taken place four days after the landing on Mars happily successful of the spatial probe Pathfinder from which it has gone out the "Sojourner" robot, telecontrolled from the JPL of the NASA, which has begun to take photos of the Martian ground and also some of these images have been transmitted in the course of the connection.


Introduction

The paper means to accentuate the increasing importance of the cooperation between the INTERNET network and the ISDN network in the parallel transmission of data, information and signals by offering a performance of the degree of feasibility of the experimentation at the service of the more advanced technology and of the medical and bioengineering science.

For facing the reading of this article from a correct perspective, it’s opportune we don't forget (see References) that it isn’t about the first experiment of telecontrol by ISDN or by INTERNET, because many experiments have already happened at international level, frequently in collaboration with the same Telerobotics Laboratory of Politecnico di Milano. In fact, this paper is presenting new results from the first transatlantic teleoperation on 1993 (Ref. /1/) and the first telerobotic surgery on a patient on 1995 (Ref. /2/).

The innovation consists in the utilisation of INTERNET+ISDN together in the same demonstration, even if the two networks are different and work on different planes. In fact, INTERNET network is at low cost, it may be maintained in a continuous connection also with various active stations and it’s addressed to transmit and to receive data in a great quantity, both by vision and sound and to manage complex files which may be transmitted also in long times. On the contrary, ISDN network presents about the same costs, but allows the connection only between two stations in the same time, with the low cost at this moment and manages signals in a immediate form. It transmits images and data in real time, depending on the light speed, except the time delay due to the passage of signals in the electronic systems for transmission and acquisition. The Telerobotics Laboratory of Politecnico di Milano, directed by Prof. Alberto Rovetta, during the teleconference with the Eighth International Conference on the Advanced Robotics (ICAR ‘97) on 8th July 1997, has succeeded in the achievement of the principal objective of his more following operational line from May 1997 to today. In fact, during the International Conference "The Hospital of the Future", which has been held from 8th to 10th May 1997 in the Kursaal of Merano, Bolzano in collaboration with the Telerobotics Laboratory of Politecnico di Milano, the INTERNET+ISDN form has been applied to the telerobotics with the attainment of a very positive result. This success has allowed to develop the form by preparing programs that make possible the remote telecontrol by means of the INTERNET and ISDN potentialities.

By considering the response times, the idea of a perfect interaction and compensation of the two networks was born: the two solutions are fit to conjugate telesurgery by an ISDN direct link, but also teledidactics and teletraining by INTERNET.


The event

On 8th July 1997 at 17.00 Italian time (8.00 a.m American time) it has begun the connection between the Telerobotics Laboratory of Politecnico di Milano and the Eighth International Conference on the Advanced Robotics (ICAR ‘97) in course at Monterey, California, from where the Prof. Alberto Rovetta has presented an experiment of telecontrol from Monterey to Milan. At 16.15 Italian time the Telerobotics Laboratory of Politecnico di Milano was already in multipoint connection through the MCU of Rome with the Aula Magna (Great Hall) of the Politecnico and with the Palace Business of the Giureconsulti of the Chamber of Commerce to allow the Rector of the Politecnico, the President of the Chamber of Commerce and Dr. A. Cecchi Paone, journalist, author-conductor of the "The Machine of the Time" broadcast, selected to coordinate and present the event in Milan, to do their discourse. From 17.00 Italian time (8.00 a.m. American time) the connection with the USA has been seen simultaneously from all the connected points. Prof. A. Rovetta from Monterey has introduced each individual application with the telecontrol phase. It has followed the comment of a series of images which have been taken by the "Sojourner" robot in the course of his exploration of the Martian ground after the landing on Mars of the Pathfinder probe on 4th July 1997. The telecontrol by INTERNET has been realised in two phases: during the first one, the telecontrol of each individual application, an ABB robot for simulation of operations of biopsy to the liver and to the breast, a mechanical hand with force feed-back, a model of a car and a scara robot of the Sankyo, easily moved by changing the digital coordinates by INTERNET and for simulation of operation of biopsy to the prostate by ISDN. During the second phase, the four applications by INTERNET have simultaneously functioned thanks to the development of a specific program called "Grove 2000" that allow to realise the telecontrol by displaying the windows relative to each structure in movement on the Server and Client interfaces of the involved computers.

Scientific and technical aspects

The connection has been supported by Alcatel and Telecom Italy (fig. 1).

From 16.00 Italian time (7.00 a.m American time) on 8th July 1997, it has been activated the ISDN connection between a 100 PCS of the Alcatel with PictureTel teleconference system, 1.6 version, present in the Telerobotics Laboratory of Politecnico di Milano and the MCU of Rome provided by Telecom Italy to realise the multipoint teleconference foreseen between the Telerobotics Laboratory of Politecnico di Milano, the Aula Magna of Politecnico and the Chamber of Commerce of Milan. The Aula Magna S01 has been connected with the MCU through the Codec CLI Rembrandt II standard audio G.722 present in the direction of the Room T04 from which it has received the audio/video signals. The Chamber of Commerce instead has been connected directly from its main room where they were present two AVC 8000 systems, one in exercise and one of backup.



At 17.00 Italian time (8.00 a.m American time) it has been established the point-to-point connection from Milano to Monterey, fundamental to the result of the operation. The call by ISDN has departed from Milan from a PCC Olivetti teleconference system with a VC8000 British Telecom card installed on an Olivetti computer and it has reached an analogous apparatus present in Monterey, where there was also a 100 PCS of the Alcatel with PictureTel teleconference system. In the Telerobotics Laboratory of Politecnico di Milano the PCC Olivetti destined to receive the audio and the video from the USA has been connected directly with a 100 PCS of the Alcatel already in multiconference through the appropriate cables to allow the same audio/video reception simultaneously to all the points connected in Monterey and in Milan. In particular an In/Out double cable has allowed the reception and distribution of the audio, while concerning the video it has been necessary to install a powerful apparatus of cameras. Substantially the video Out from the PCC by passing across the 4 entry of the Laboratory video entries selector has become video In in the 100 PCS, as also the video Out of the PCS by passing across a VGA/PAL converter provided from the Alcatel and by entering in the PCC video entries selector has become video In in the PCC. Two Alcatel PC, one in exercise and one of backup, connected with two special dedicated Telecom Italy INTERNET lines with direct access to Interbusiness have been prearranged for the telecontrol by INTERNET. Concerning the telecontrol of the scara robot of the Sankyo (fig. 2), a switch has been inserted by choosing the INTERNET formality or the ISDN formality. The powerful apparatus of cameras can be divided in two blocks: the first of the colours environmental cameras at high definition to frame the Sankyo robot, the ABB robot, the mechanical hand and the model of a car; the second of the black and white cameras to frame the details of the structure of the scara robot in movement.


1

Figure 2: The scara robot of the Sankyo

In the first phase of the demonstration it has been realised the telecontrol by INTERNET thanks to the development of four specific Client/Server applications with the TCP/IP protocol by using the last version of Visual Basic, 5.0 version. Additionally it has been realised a final summary program called "Grove 2000" that allows the simultaneous telecontrol of the four applications by displaying the four relative windows in the monitor. Normally a Quickcam connected with the Server computer could send the visual feed-back to the remote Client, but in this case the frame has been realised by means of environmental cameras connected with the computer used for the teleconference. The first application telecontrolled by INTERNET in the course of the demonstration concerns an industrial robot of the ABB Robotics with six degrees of liberty (fig. 3) to perform simulations of operations of biopsy to the liver and to the breast also in a continuous sequence. The TCP/IP protocol foresees the development of a program for the Server and of a twin one for the Client (the Client computer used in the USA by Prof. A. Rovetta was a portable computer of the AST). For the ABB robot the interface of the Server program offers two opportunities to impart the movement to the robot. Not before being insured that the blue button has become red by passing from "not connected" to "connected" the movement will be sent to the robot like a predefinite program in the inferior buttons of the menu or directly like coordinates which have been selected in the "X-Y", "Z", "Speed" and "Alpha, Beta, Gamma Angles" windows by means of the mouse.Once the formality of movement, by program or by coordinates, has been selected, it needs to operate the "Send" button and, if all it evenly proceeds, from the red rectangle of the menu will appear the "received command" message. The "Chat" button allows to establish the written communication with a Client program in the course of the connection. The "Text" window shows the values of coordinates, angles and speed which have been sent to the robot command.

2

Figure 3: The ABB robot

The second application and the third one telecontrolled by INTERNET have been the mechanical hand with force feed-back (fig. 4) and a model of a car (fig. 5).

The mechanical hand constituted by a mechanism able to move a finger by means of a strain applied to an electric motor could receive the strain like a remote signal by INTERNET or directly like result of a force applied on a load cell of a biorobotic system (VREPAR: Virtual Reality Environments for Psycho-neuro-physiological Assessment Rehabilitation) developed to value neuromotor responses of patients affected with the Parkinson’s disease.


3

Figure 4: The mechanical hand

 

The model of a car has been commanded by infrared signal telecommanded by a strain signal received in a Server computer in which it has been installed a card of data acquisition able to emit an exit signal to the control.

The fourth application, a scara SC 3000 industrial robot of the Sankyo with four degrees of liberty (fig. 2), programmed to perform simulations of operations of biopsy to the prostate, has been telecontrolled through the same serial entry of the computer by INTERNET and by ISDN.

At the end from the Jet Propulsion Laboratory of the NASA, USA have been sent and commented the images which have been taken by the "Sojourner" robot in the course of his exploration of the Martian ground.


4

The demonstration shows that two parallel networks for communication may be integrated. Because of the unforeseen (up to now) times of the INTERNET network, the system may transmit images which are on parking, also for a long time and may move the support structures for the surgery, may prepare the surgeon table, may analyze the results of the surgeon operation and transmit them as static data in the medical network. INTERNET network may permit slow operations, with a high quantity of information. On the contrary, the ISDN network time delay, already studied in previous researches in the Telerobotics Laboratory of Politecnico di Milano in cooperation with Dr. A. Bejczy, JPL, Pasadena, may be foreseen with a certain precision. The developed system uses the ISDN line and transmits the data of the patient, of the surgical operation and takes part on the basis of the diagnostic analysis of the physician.

Results

The appointed objective has been fully achieved. A further level of certainty in the feasibility of the telecontrol by INTERNET+ISDN has been achieved. From the International Congress of Merano "The Hospital of the Future" from 8th to 10th May 1997, in the course of which for the first time it has been applied the INTERNET+ISDN form to the Eighth International Conference on the Advanced Robotics (ICAR ‘97) many tests and experimentations have accompanied the scientific and technical way of the Telerobotics Laboratory of Politecnico di Milano in the direction of a notable progress in acquaintance and evaluation of reliability in the application of the INTERNET and ISDN networks not only in the field of the telecontrol of medical robotics and bioengineering applications.


Future developments

The Telerobotics Laboratory of Politecnico di Milano means to continue along the directive of experimentation of the INTERNET+ISDN form, above all in the field of the telerobotics and telehealth by exposing the results in the most important international conferences that will take place in the future in order to compare and to discuss the achieved results.


Conclusions

The demonstration has allowed to open and develop a new frontier: the operative interconnection of Internet and ISDN. In the teleconnection with the Congress of Merano "The Hospital of the Future" the INTERNET+ISDN form has been developed in the field of the telehealth like tool of prevention, for diagnosis, therapy, assistance at a long distance and training; in the connection with ICAR ‘97 has been used to develop programs of telecontrol of medical robotics and bioengineering applications.

Concluding, the INTERNET network is at low cost and allows the telecontrol with unforeseen (up to now) time delay; it may collect and transmit a great quantity of data at a long distance by allowing simultaneously several Clients to intervene and to actuate the Server computer without competition. The test on such share are on development. The ISDN network is at about the same low cost and it’s able to have a high efficiency for quick actions and for transmission and share of audio and visual signals in a small quantity, but allows the connection only between two stations in the same time.


Acknowledgements

The Authors thank Dr. A. Bejczy and Eng. P. Fiorini of the Jet Propulsion Laboratory of the NASA, USA, Prof. F. Falcone and Mr. C. Coniglio for the cooperation, the undergraduate students of the Telerobotics Laboratory of Politecnico di Milano for the connections and the software development.

Special thanks to: Eng. G. Gislon and Dr. G. Melini of the Alcatel, Eng. P. Leone and Eng. P. Conca of the ABB Robotics, Eng. F. Meacci of the Telecom Italy for the technical and scientific support and for the teleconference equipment; Prof. A. De Maio, Rector of Politecnico di Milano and Dr. P. Bassetti, President of the Chamber of Commerce of Milan for the hospitality, Dr. A. Cecchi Paone, journalist, author-conductor of the "The Machine of the Time" broadcast, for the presentation of the connection.


References

/1/ A. Rovetta, R. Sala, F. Cosmi, X. Wen, D. Sabbadini, S. Milanesi, A. Togno, L. Angelini, A. Bejczy, Telerobotic Surgery in a Transatlantic Experiment: Application in Laparoscopy, Proceed. Telemanipulator Technology and Space Telerobotics, Boston, September 1993

/2/ A. Rovetta, R. Sala, Robotics and telerobotics applied to a prostatic biopsy on a human patient, Second Symposium on Medical Robotics and Computer Assisted Surgery, Baltimore, November 1995

/3/ A. Rovetta, R. Sala, F. Cosmi, X. Wen, S. Milanesi, D. Sabbadini, A. Togno, L. Angelini, A. Bejczy, A New Telerobotic Application: Remote Laparoscopic Surgery Using Satellites and Optical Fiber Networks for Data Exchange, The International Journal of Robotics Research, Vol. 15, N. 3, June 1996

/4/ A. Rovetta, A. Bejczy, R. Sala, Telerobotic Surgery: Applications On Human Patients and training With Virtual Reality, Congress "Medicine Meets Virtual Reality", San Diego, January 1997

/5/ A. Rovetta, F. Falcone, R. Sala, M. E. Garavaldi, Telehealth in Africa, Congress "Medicine Meets Virtual Reality", San Diego, January 1997

/6/ A. Rovetta, Internet plus ISDN: a parallel cooperative transmission for telehealth in the hospital of the future, Conclusive Article after the Congress of Merano, Bolzano, "The Hospital of the Future", May 1997

 

 
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