Network latency and long‐distance robotic telestenting: Exploring the potential impact of network delays on telestenting performance

Madder, Ryan D.; VanOosterhout, Stacie; Mulder, Abbey; Bush, Jared; Martin, Samuel P.; Rash, Adam; Tan, Jose; Parker, Jessica; Kalafut, Andrew J.; Yao, Li; Kottenstette, Nicholas; Bergman, Per; Nowak, Brent M.

doi:10.1002/ccd.28425

Cited by 33 publications

(30 citation statements)

References 9 publications

(26 reference statements)

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“…Remote robotic assistance in endovascular surgery allows the operator to perform the intervention even while the operator is physically in a separate location from the patient. Although locally performed robotic-assisted endovascular procedures have been introduced to interventional cardiology, peripheral, and neurovascular surgery [1,[6][7][8], previous tele-robotic studies only investigate the feasibility and characteristics of percutaneous coronary interventions [3,5].…”

Section: Discussionmentioning

confidence: 99%

“…came to the conclusion that latencies during tele-robotic coronary navigation were perceptible for the operator at 400 ms or above [3].…”

Section: Discussionmentioning

confidence: 99%

“…The feasibility of percutaneous coronary intervention (PCI) from long geographic distances has been previously described in both animal models and humans [3][4][5], but telerobotic peripheral and neurovascular intervention has not been demonstrated yet.…”

Section: Introductionmentioning

confidence: 99%

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Impact of network performance on remote robotic-assisted endovascular interventions in porcine model

et al. 2021

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Remote robotic-assisted endovascular interventions require real-time control of the robotic system to conduct precise device navigation. The delay (latency) between the input command and the catheter response can be affected by factors such as network speed and distance. This study evaluated the effect of network latency on robotic-assisted endovascular navigation in three vascular beds using in-vivo experimental model. Three operators performed femoral, carotid, and coronary endovascular robotic navigation blinded from the hybrid room with the prototype remote-enabled CorPath GRX system in a porcine model. Navigation was performed to different targets with randomly assigned network latencies from 0 to 1000 ms. Outcome measurements included navigation success, navigation time, perceived lag (1 = imperceptible, 5 = too long), and procedural impact scored by the operators (1 = no impact, 5 = unacceptable). Robotic-assisted remote endovascular navigation was successful in all 65 cases (9 femoral, 38 external carotid, 18 coronary). Guidewire times were not significantly different across the simulated network latency times. Compared to 0 ms added latency, both the procedural impact and perceived lag scores were significantly higher when the added latency was 400 ms or greater (< 0.01). Remote endovascular intervention was feasible in all studied anatomic regions. Network latency of 400 ms or above is perceptible, although acceptable to operators, which suggests that remote robotic-assisted femoral, carotid or coronary arterial interventions should be performed with network latency below 400 ms to provide seamless remote device control.

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Section: Discussionmentioning

confidence: 99%

“…came to the conclusion that latencies during tele-robotic coronary navigation were perceptible for the operator at 400 ms or above [3].…”

Section: Discussionmentioning

confidence: 99%

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Impact of network performance on remote robotic-assisted endovascular interventions in porcine model

et al. 2021

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“…Examples of useful recent applications of teleoperation range from space operations, military (Chen, 2010 ), underwater exploration (Saltaren et al, 2007 ), mining, nuclear/toxic material handling, military, and robotic-assisted medical interventions (Madder et al, 2019 ). Figure 1 shows three applications from our laboratory, which includes three remote users of medical, space, and ground robots.…”

Section: Introductionmentioning

confidence: 99%

“…Figure 1 shows three applications from our laboratory, which includes three remote users of medical, space, and ground robots. A recent paper in medical robotics (Madder et al, 2019 ) studied the effect of time delay on a robotic coronary telestenting system. They use a robotic system at distances over 100 miles and simulate network latency from 0 to 1,000 ms.…”

Section: Introductionmentioning

confidence: 99%

A Brief Survey of Telerobotic Time Delay Mitigation

2020

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There is a substantial number of telerobotics and teleoperation applications ranging from space operations, ground/aerial robotics, drive-by-wire systems to medical interventions. Major obstacles for such applications include latency, channel corruptions, and bandwidth which limit teleoperation efficacy. This survey reviews the time delay problem in teleoperation systems. We briefly review different solutions from early approaches which consist of control-theory-based models and user interface designs and focus on newer approaches developed since 2014. Future solutions to the time delay problem will likely be hybrid solutions which include modeling of user intent, prediction of robot movements, and time delay prediction all potentially using time series prediction methods. Hence, we examine methods that are primarily based on time series prediction. Recent prediction approaches take advantage of advances in nonlinear statistical models as well as machine learning and neural network techniques. We review Recurrent Neural Networks, Long Short-Term Memory, Sequence to Sequence, and Generative Adversarial Network models and examine each of these approaches for addressing time delay. As time delay is still an unsolved problem, we suggest some possible future research directions from information-theory-based modeling, which may lead to promising new approaches to advancing the field.

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Remote robotic percutaneous coronary intervention: An animal feasibility study

Eleid

Zheng

Gulati

et al. 2020

Cathet Cardio Intervent

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Objectives The purpose of this study was to explore the feasibility and safety of robotic PCI performed using an off‐siteremote‐control system in an animal model. Background Access to primary percutaneous coronary intervention (PCI) remains a challenge in acute myocardial infarction management. The combination of telemedicine and robotic PCI allow the potential delivery of primary PCI to remote locations without the delay of transfer. Methods This single‐center prospective pilot preclinical feasibility study compared robotic PCI with remote PCI on swine across three stages (adjacent room, different floor of the same building, two different buildings). Latency up to 1,000 ms was introduced into the operating environment to simulate decreased network quality (blinded to operator). The primary outcome measures were technical success and acute safety. The secondary outcome measures included lesion wiring time, procedural time and qualitative scoring of the PCI experience by the operator. Results Across 52 experiments in 15 animals, technical success was 100%. No procedural complications occurred during the study. No significant difference in lesion treatment time was detected between stages (p = .11) and between time per target vessel when latency up to 1,000 ms was introduced (p = .58). Injected delay >250 ms had the greatest impact on procedure perceived lag. Longer procedure time was associated with lower procedure impact score, regardless of injected latency. Conclusions Remote robotic PCI was feasible and safe in an animal model. Procedural duration was acceptable and unaffected by network latency. Future studies are needed to determine the safety and feasibility of remote PCI in humans.

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Network latency and long‐distance robotic telestenting: Exploring the potential impact of network delays on telestenting performance

Cited by 33 publications

References 9 publications

Impact of network performance on remote robotic-assisted endovascular interventions in porcine model

Impact of network performance on remote robotic-assisted endovascular interventions in porcine model

A Brief Survey of Telerobotic Time Delay Mitigation

Remote robotic percutaneous coronary intervention: An animal feasibility study

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