Saturday was my last day at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2013 conference. The day started off bright and early with a series of presentations focusing on advancements in military surgery. I was particularly excited for this presentation, knowing that the US military has played a role in the development of many examples of cutting edge technology. To give an example from the medical world, Intuitive Surgical's da Vinci robot is based on a robotic telesurgery system that was developed for the US military, to allow surgeons to operate from a safe distance on soldiers injured in battle.
 
A presentation from Dr Mehran Anvari (of McMaster University) gave an update on the progress of robotic telesurgery. Dr. Mehran is a leading expert on telerobotic surgery?he performed the first telerobotic surgical procedure in the world in 2003, operating laparoscopically on a patient who was 400 miles away. His presentation highlighted some of the hurdles that are preventing the uptake of this technology; for example, surgeons have to cope with a time lag between when they give the initial command and when the robot actually performs the action. Advancements have significantly shortened this gap?currently, the delay stands at a few hundred milliseconds?but it can still be difficult to adjust to initially. Surgeons can make this adjustment easier by slowing down the steps of the procedure. In addition, any interruptions in the power supply or communication signal can be deadly to the patient. Dr. Mehran suggests that surgeons can overcome this concern by having additional backup sources of power and communication. In the future, telerobotic surgery will be key for patients who live in distant areas?anywhere from secluded rural communities or even space stations?who require critical operations from skilled surgeons.
 
Another interesting presentation was given by Dr. Thomas Nelson, who spoke on the Cut Suit, a device used in military training for surgeons that simulates the skin, bones, blood, and internal tissue of the human torso. Click here for a video of what the device looks like. With the Cut Suit, a surgeon who is used to working only in the operating room of a civilian hospital can prepare for the intensity of dealing with battlefield injuries, which often include extremity loss and hemorrhaging, collapsed lungs, and severe damage to abdominal internal organs. For optimal training, simulations are carried out with a live actor, beginning from the point of injury and following through to transportation and then surgical intervention. In terms of applications to the treatment of civilians, this kind of technology could be used for training new surgeons who want to work with trauma cases in the emergency room.
 
Overall, it was made clear at SAGES that ongoing innovation?without any compromises in patient safety?is a major priority for this group of surgeons. With many presentations and posters on robotics, natural orifice transluminal endoscopic surgery (NOTES), single-incision laparoscopy, and cutting-edge implantable medical devices, the future of minimally invasive surgery is certainly exciting. I look forward to seeing the progress of these technologies throughout 2013. 

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