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This paper presents an historic achievement. A commercial robotic surgical system was altered to enable remote surgery. This presented huge challenges because the Zeus/sup TM/ system is a tightly-coupled electromechanical system with tight sample and communication loops. We were, however, able to separate Zeus/sup TM/ into a remote surgeon-side system (located in New York City) and a patient-side system (located in Strasbourg, France). Never before have surgeons performed complete surgical tasks in the fashion presented in this paper. The remote surgical task was Laparoscopic Cholecystectomy (removal of the gall bladder) performed on animals. In this unique setup the patient (pig) was readied in the operating room in Strasbourg, France, while the operating surgeon was in Manhattan, NY. The Zeus/sup TM/ robotic system is a very safe surgical system for use in the operating room. For the remote transatlantic case, numerous safety features were built on top of those already available in Zeus/sup TM/. The ultimate goal of this development is to perform a transatlantic Lap Chole case on a human subject. As such, the animal cases were performed with the same setup, personnel, and equipment as will be used for the human case. The choices of the robotic system, networking equipment, and telecommunications lines were critical to the success of the project.
Ghodoussi et al. (Wed,) studied this question.