Robotization

  • Thomas M. Hemmerling
  • Nora Terrasini
  • Shantale Cyr
Chapter

Abstract

Robots in the acute care environment can be divided into telepresence, pharmacological, and manual robots. Telepresence robots are mobile audio-video-equipped communication stations which allow physicians to communicate with health-care personnel and patients remotely including access to digital patient data. They make access to specialist care possible without direct physical communication. They improve nursing care satisfaction and can improve outcome; they are currently available in many countries for standard care with reasonable cost involved. Pharmacological robots use closed-loop systems to deliver parts of anesthesia, hypnosis, analgesia, or muscle relaxation, or complete anesthesia automatically. They are at present research tools showing better performance than human-controlled anesthesia. The SEDASYS system is the only commercially available closed-loop system; it delivers sedation for colonoscopies in a mixture of closed-loop feedback and physician control. It is controversial because it allows manual change of infusion and bolus application of propofol by non-anesthesiologists. Manual robots are currently under development in the research setting; they assist with manual anesthetic gestures, such as intubation and nerve blocks. Only two of such systems, the Kepler intubation system and the Magellan, have been tested in humans in pilot studies. Telemedicine in the acute care environment has enabled teleconsultation and monitoring, teletherapeutic administration of propofol or general anesthesia across continents. Robotization in the acute care environment has started; the future will see more research in this exciting new field of acute care medicine with more widespread use of current telepresence robots and the introduction of commercially available pharmacological or manual robots into daily practice.

Keywords

Fatigue Catheter Ischemia Syringe Assure 

References

  1. 1.
  2. 2.
    Hemmerling TM. Automated anesthesia. Curr Opin Anaesthesiol. 2009;22(6):757–63.PubMedCrossRefGoogle Scholar
  3. 3.
    Vespa PM, Miller C, Hu X, Nenov V, Buxey F, Martin NA. Intensive care unit robotic telepresence facilitates rapid physician response to unstable patients and decreased cost in neurointensive care. Surg Neurol. 2007;67(4):331–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Rincon F, Vibbert M, Childs V, Fry R, Caliguri D, Urtecho J, et al. Implementation of a model of robotic tele-presence (RTP) in the neuro-ICU: effect on critical care nursing team satisfaction. Neurocrit Care. 2012;17:97–101.PubMedCrossRefGoogle Scholar
  5. 5.
    Ito K, Sugano S, Takeuchi R, Nakamura K, Iwata H. Usability and performance of a wearable tele-echography robot for focused assessment of trauma using sonography. Med Eng Phys. 2013;35:165–71.PubMedCrossRefGoogle Scholar
  6. 6.
    Ito K, Tsuruta K, Sugano S, Iwata H. Evaluation of a wearable tele-echography robot system: FASTele in a vehicle using a mobile network. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:2093–6.PubMedGoogle Scholar
  7. 7.
    Hemmerling TM, Zaouter C, Tang L, Charabati S, Mathieu PA. McSleepy - a novel completely automatic anesthesia delivery system: performance evaluation in comparison to manual control in abstracts of 2010 CAS meeting. Can J Anesth. 2010;57:116.CrossRefGoogle Scholar
  8. 8.
    Hemmerling TM, Charabati S, Salhab E, Bracco D, Mathieu PA. The analgoscore: a novel score to monitor intraoperative nociception and its use for closed-loop application of remifentanil. J Comput. 2009;4(4):311–8.Google Scholar
  9. 9.
    Puri GD, Kumar B, Aveek J. Closed-loop anaesthesia delivery system (CLADS) using bispectral index: a performance assessment study. Anaesth Intensive Care. 2007;35(3):357–62.PubMedGoogle Scholar
  10. 10.
    Liu N, Chazot T, Hamada S, Landais A, Boichut N, Dussaussoy C, et al. Closed-loop coadministration of propofol and remifentanil guided by bispectral index: a randomized multicenter study. Anesth Analg. 2011;112(3):546–57.PubMedCrossRefGoogle Scholar
  11. 11.
    Hemmerling TM, Arbeid E, Tang L, Cyr S, Wehbe M, Zaouter C. HSS- a novel hybrid system for conscious sedation. In abstracts of the 2011 annual meeting of the Society for Technology in Anesthesia (STA). January 12–15, 2011. Las Vegas, Nevada, USA. Anesth Analg. 2011;113(2 Suppl):39.Google Scholar
  12. 12.
    Pambianco DJ, Vargo JJ, Pruitt RE, Hardi R, Martin JF. Computer-assisted personalized sedation for upper endoscopy and colonoscopy: a comparative, multicenter randomized study. Gastrointest Endosc. 2011;73(4):765–72.PubMedCrossRefGoogle Scholar
  13. 13.
    Pambianco DJ, Whitten CJ, Moerman A, Struys MM, Martin JF. An assessment of computer-assisted personalized sedation: a sedation delivery system to administer propofol for gastrointestinal endoscopy. Gastrointest Endosc. 2008;68(3):542–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Cote GA. The debate for nonanesthesiologist-administered propofol sedation in endoscopy rages on: who will be the “King of Prop?”. Gastrointest Endosc. 2011;73(4):773–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Martin JF, Bridenbaugh P, Gustafson M. The SEDASYS system is not intended for the sedation of high-risk patients. Gastrointest Endosc. 2011;74(3):723.PubMedCrossRefGoogle Scholar
  16. 16.
    Tighe PJ, Badiyan SJ, Luria I, Lampotang S, Parekattil S. Robot-assisted airway support: a simulated case. Anesth Analg. 2010;111(4):929–31.PubMedCrossRefGoogle Scholar
  17. 17.
    Hemmerling TM, Wehbe M, Zaouter C, Taddei R, Morse J. The Kepler intubation system. Anesth Analg. 2012;114(3):590–4.PubMedCrossRefGoogle Scholar
  18. 18.
    Hemmerling TM, Taddei R, Wehbe M, Zaouter C, Cyr S, Morse J. First robotic tracheal intubations in humans using the Kepler intubation system. Br J Anaesth. 2012;108:1011–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Tighe PJ, Badiyan SJ, Luria I, Boezaart AP, Parekattil S. Technical communication: robot-assisted regional anesthesia: a simulated demonstration. Anesth Analg. 2010;111(3):813–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Wehbe M, Morse J, Taddei R, Cyr S, Hemmerling TM. The MagellanTM first robotic ultrasound-guided nerve block in humans. In: Annual meeting of the Society for Technology in Anesthesia (STA). 2012; Palm Beach.Google Scholar
  21. 21.
    Webhe M, Morse J, Taddei R, Cyr S, Hemmerling TM. Automatic ultrasound nerve detection. In: Annual meeting of the Society for Technology in Anesthesia (STA). 2012; Palm Beach.Google Scholar
  22. 22.
    Ihmsen H, Naguib K, Schneider G, Schwilden H, Schuttler J, Kochs E. Teletherapeutic drug administration by long distance closed-loop control of propofol. Br J Anaesth. 2007;98(2):189–95.PubMedCrossRefGoogle Scholar
  23. 23.
    Hemmerling TM, Arbeid E, Tang L, et al. Transcontinental anesthesia in “abstracts of the 2011 annual meeting of the Society for Technology in Anesthesia (STA)”. January 12–15, 2011. Las Vegas, Nevada, USA. Anesth Analg. 2011;113(2 Suppl):42.Google Scholar
  24. 24.
    Cone SW, Gehr L, Hummel R, Rafiq A, Doarn CR, Merrell RC. Case report of remote anesthetic monitoring using telemedicine. Anesth Analg. 2004;98(2):386–8, table of contents.PubMedCrossRefGoogle Scholar
  25. 25.
    Fiadjoe J, Gurnaney H, Muralidhar K, Mohanty S, Kumar J, Viswanath R, et al. Telemedicine consultation and monitoring for pediatric liver transplant. Anesth Analg. 2009;108(4):1212–4.PubMedCrossRefGoogle Scholar
  26. 26.
    Wong DT, Kamming D, Salenieks ME, Go K, Kohm C, Chung F. Preadmission anesthesia consultation using telemedicine technology: a pilot study. Anesthesiology. 2004;100(6):1605–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Terrasini N, Moreno P, Wehbe M, Morse J, Cyr S. Hemmerling TM. Remote airway assessment. 2012 Annual meeting of the American Society of Anesthesiologists. (Abstract A577). 2012; Washington, DC.Google Scholar

Suggested Readings

  1. Chatrath V, Attri JP, Chatrath R. Telemedicine and anaesthesia. Indian J Anaesth. 2010;54(3):199–204.PubMedCrossRefGoogle Scholar
  2. Galvez JA, Rehman MA. Telemedicine in anesthesia: an update. Curr Opin Anaesthesiol. 2011;24(4):459–62.PubMedCrossRefGoogle Scholar
  3. Hemmerling TM. Automated anesthesia. Curr Opin Anaesthesiol. 2009;22(6):757–63.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Thomas M. Hemmerling
    • 1
  • Nora Terrasini
    • 2
  • Shantale Cyr
    • 1
  1. 1.Department of AnesthesiologyMontreal General HospitalMontrealCanada
  2. 2.IV Anestesia e RianimazioneOspedale Cisanello PisaPisaItaly

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