The MIDSTEP system for ultrasound guided remote telesurgery

MIDSTEP (Multimedia Interactive DemonStrator TElepresence) was a telepresence research project within the EU ACTS framework, designed to demonstrate the feasibility of remote telesurgery. The project had the principle objective of realising two telesurgery demonstration systems; one for 'local' telemanipulation over LAN and one for remote telemanipulation over WAN. Both demonstrators utilised remote robotic manipulation of an ultrasound probe, controlled by an expert ultrasonographer, to guide a surgeon at the patient site in performing simple invasive surgical tasks. The 'local' telemanipulation system was designed to allow an ultrasound expert to monitor a minimal invasive laparoscopic procedure by viewing the ultrasound image from a laparoscopic ultrasound probe. The expert was able to interpret the transmitted images and remotely move the ultrasound probe from a zoom adjacent to the operating room. The remote telesurgery system was designed to allow a remote ultrasound expert to perform a simple ultrasound guided biopsy, where the expert is located in a different hospital to where the patient and biopsy procedure is to take place. This paper presents the demonstrators generic architecture and results of the design features to overcome safety critical problems encountered in remote surgery.