THE ROBOT IS IN
Artificial intelligence has invaded the medical world, serving in roles from scrub nurse to doctor's stand-in
BY DELTHIA RICKS
STAFF WRITER
July 12, 2005
Close your eyes and imagine: A patient is anesthetized, draped and on an operating table. The other humans - doctors and nurses - are gowned and masked. A metallic assistant, perhaps a distant cousin to R2D2 of "Star Wars" fame, is standing by. Then the surgeon calls out for instruments:
Scalpel.
Scissors.
Retractor.
Kelly clamp.
And this is where science fiction starts blending eerily into a new health care reality: A slender robotic arm reaches toward a tray. And with each command, "she" hands instruments quickly, efficiently, correctly.
Meet Penelope, the new scrub nurse at New York Presbyterian Hospital in Manhattan: a robot with a job that in many hospitals is held by humans with college degrees. Penelope is not just any old robot, but one blessed with artificial intelligence, an ability to "see" and the capacity to "hear." Her human colleagues call her a star employee.
Freeing up a nurse
"She's not here to replace a nurse. She's here to free up a nurse, to let nurses spend more time with the patients," said registered nurse Doreen Taliaferro, who herself has worked in the scrub role at New York Presbyterian. Taliaferro said she is not the least bit threatened by Penelope's presence.
"There is far more important work for human nurses to perform," she said. Nevertheless, Taliaferro has had questions. One thing on her mind was Penelope's cost. She asked the robot's developer, who responded: About $60,000 to $70,000, the price range for a portable X-ray machine, and slightly less than the annual salary of an RN.
Penelope is the brainchild of Dr. Michael Treat, a surgeon and inventor at the hospital whose background in physics helped Penelope leap from an imagined figure in his mind to a real-life robot holding down a job at a premier hospital in New York City.
Although robots have been used in operating rooms for more than two decades, they've mostly served as tools to help improve surgeons' skills. Penelope's introduction marks the first time that a robot has worked in a hospital as a personal assistant, Treat said. Penelope takes a surgeon's commands and acts independently.
Technically known as the Penelope Surgical Instrument Server, the device was developed through a technology start-up company headed by Treat in Manhattan.
The robot's artificial intelligence enables it to be smarter than the average computer. Artificial intelligence is a branch of computer science, sometimes called neural networks, in which scientists program computers to respond as if they were thinking.
Through highly sophisticated programming, Penelope is capable of reasoning and making choices. Ultimately, Treat hopes to endow the robot with the ability to "learn" new skills and adapt to new situations.
Currently, the robot is able to identify surgical instruments and retrieve them. It is a self-contained unit on a mobile stand, which makes it easy to transfer from one operating room to another.
Robo-mania
Treat confesses to a lifelong fascination with robots, dating back to the late 1950s when, as a child, he thought the small, battery-powered Robby the Robot was the coolest - although a tad unsophisticated and a bit clumsy. Robby's arms looked like a couple of Black & Decker wrenches. Treat knew one day he could build a better machine.
So captivated has he remained that to this day he thinks everyone should have his or her own personal robot. Hospitals, Treat said, are ideal places for robots to work.
"I've done a lot of other things, developed other surgical instruments and endoscopic tools," Treat said in a recent interview. "I am a chronic inventor, and I can't stop."
In addition to inventing Penelope, he developed a surgical method that uses heat to make incisions without scalpels and then seals the wound when an operation is over. Knives, needles, staples and stitches never come into play.
"I am sort of a physicist who is also practicing surgery. I have been trying throughout my career to use physics to improve medicine. I chose surgery because I figured that's where I'd basically apply technology." Along with his M.D., Treat holds undergraduate and master's degrees in physics.
With the invention of Penelope, Treat allowed his imagination to soar.
"I think we are now with personal robots where personal computers were a couple of decades ago," Treat said. "Twenty-two or 23 years ago, computers were big machines that worked in big companies, and PCs that interacted with you were new.
"This is a science-fiction moment. We now have an autonomous robot capable of projecting ahead because she has reason to believe you'll need a certain instrument in a moment. So she's not a power assist, she's a coworker like R2D2. A stand-on-its-own kind of entity."
Dr. Spencer Amory, director of surgery at New York Presbyterian, described the device as highly efficient and an excellent helper in the operating room.
Improving precision
In hospitals large and small, robots have been invading all aspects of day-to-day routine.
At Mercy Medical Center in Rockville Centre, a robot by the name of Galileo assists in total-knee replacement surgery.
Dr. Jan Albert Koenig, director of orthopedics at Mercy, said the robot has enabled him to perform knee surgeries that are extraordinarily precise, zeroing in on the exact spots where bones need to be cut.
"Before this technology, a good surgeon would be about 75 percent accurate," Koenig said. "With the robot, we now have 99 percent accuracy."
Still, he confesses that robots have their limits: "It doesn't replace the surgeon or the scrub team or anyone else in the OR [operating room]. But it is a helper," Koenig said.
Handling drugs, specimens
At Winthrop-University Hospital in Mineola, a robot by the name of Walter fills prescriptions in the pharmacy. At the Cleveland Clinic in Ohio, a robot picks up patients' blood samples, then takes an elevator to ferry the specimens to the lab.
Dr. Garth Ballantyne of Hackensack University Hospital in New Jersey works with a robot that allows him to be in two places at once. According to a report in the Journal of the American Medical Association, Ballantyne can be out of town at a medical convention and still be able to complete hospital rounds at home.
The robot, which has a flat-screen monitor as its head, wheels from one patient's room to another. Ballantyne's image is beamed in. He is able to inquire about his patient's health even though he may be thousands of miles away.
Treat, meanwhile, a fan of Issac Asimov's "I, Robot," a tale in which an uprising among the machines threatens humans, doesn't think robots will ever go that far. "There are scads of innovative things going on in this field now. I can see robots that help kids learn in school. Robots as personal companions. More robots in hospitals. We're at the very beginning, and the future looks very bright."
Copyright 2005 Newsday Inc.
|
