IRNS: a system for telerobotic surgical mentoring

The Integrated Remote Neurosurgical System (IRNS) is a robotic neurosurgical microscope remotely-operated through the utilization of high-speed communications and a surgeon-accessible computer interface. The intended use of this system is for surgical mentoring of a operating-room (OR) surgical team by a remote expert surgeon. In the design of the IRNS, we emphasized trying to give the remote surgeon the feeling of actually being in the OR-a sense of telepresence. This is accomplished through the use of bidirectional audio, video white-boarding on the microscope view, site cameras, voice recognition, bilateral access to the patient's images and an interface to our presurgical planning software. The IRNS also includes several methods to control the remote microscope and its functions, including rotation, translation, focus and zoom. Several safety precautions are implemented including the condition that any remote manipulation of the microscope is possible only when the local operator actively permits it by holding down a "dead-man" switch. The remote and local OR sites are integrated using an asynchronous transfer mode (ATM) switched network link.