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TODAY'S PAPER
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NewsHealth

THE ROBOT IS IN

Close your eyes and imagine: A patient is anesthetized,

draped and on an operating table. The other humans - doctors and nurses - are

gowned and masked. A metallic assistant, perhaps a distant cousin to R2D2 of

"Star Wars" fame, is standing by. Then the surgeon calls out for instruments:

Scalpel.

Scissors.

Retractor.

Kelly clamp.

And this is where science fiction starts blending eerily into a new health

care reality: A slender robotic arm reaches toward a tray. And with each

command, "she" hands instruments quickly, efficiently, correctly.

Meet Penelope, the new scrub nurse at New York Presbyterian Hospital in

Manhattan: a robot with a job that in many hospitals is held by humans with

college degrees. Penelope is not just any old robot, but one blessed with

artificial intelligence, an ability to "see" and the capacity to "hear." Her

human colleagues call her a star employee.

Freeing up a nurse

"She's not here to replace a nurse. She's here to free up a nurse, to let

nurses spend more time with the patients," said registered nurse Doreen

Taliaferro, who herself has worked in the scrub role at New York Presbyterian.

Taliaferro said she is not the least bit threatened by Penelope's presence.

"There is far more important work for human nurses to perform," she said.

Nevertheless, Taliaferro has had questions. One thing on her mind was

Penelope's cost. She asked the robot's developer, who responded: About $60,000

to $70,000, the price range for a portable X-ray machine, and slightly less

than the annual salary of an RN.

Penelope is the brainchild of Dr. Michael Treat, a surgeon and inventor at

the hospital whose background in physics helped Penelope leap from an imagined

figure in his mind to a real-life robot holding down a job at a premier

hospital in New York City.

Although robots have been used in operating rooms for more than two

decades, they've mostly served as tools to help improve surgeons' skills.

Penelope's introduction marks the first time that a robot has worked in a

hospital as a personal assistant, Treat said. Penelope takes a surgeon's

commands and acts independently.

Technically known as the Penelope Surgical Instrument Server, the device

was developed through a technology start-up company headed by Treat in

Manhattan.

The robot's artificial intelligence enables it to be smarter than the

average computer. Artificial intelligence is a branch of computer science,

sometimes called neural networks, in which scientists program computers to

respond as if they were thinking.

Through highly sophisticated programming, Penelope is capable of reasoning

and making choices. Ultimately, Treat hopes to endow the robot with the ability

to "learn" new skills and adapt to new situations.

Currently, the robot is able to identify surgical instruments and retrieve

them. It is a self-contained unit on a mobile stand, which makes it easy to

transfer from one operating room to another.

Robo-mania

Treat confesses to a lifelong fascination with robots, dating back to the

late 1950s when, as a child, he thought the small, battery-powered Robby the

Robot was the coolest - although a tad unsophisticated and a bit clumsy.

Robby's arms looked like a couple of Black & Decker wrenches. Treat knew one

day he could build a better machine.

So captivated has he remained that to this day he thinks everyone should

have his or her own personal robot. Hospitals, Treat said, are ideal places for

robots to work.

"I've done a lot of other things, developed other surgical instruments and

endoscopic tools," Treat said in a recent interview. "I am a chronic inventor,

and I can't stop."

In addition to inventing Penelope, he developed a surgical method that uses

heat to make incisions without scalpels and then seals the wound when an

operation is over. Knives, needles, staples and stitches never come into play.

"I am sort of a physicist who is also practicing surgery. I have been

trying throughout my career to use physics to improve medicine. I chose surgery

because I figured that's where I'd basically apply technology." Along with his

M.D., Treat holds undergraduate and master's degrees in physics.

With the invention of Penelope, Treat allowed his imagination to soar.

"I think we are now with personal robots where personal computers were a

couple of decades ago," Treat said. "Twenty-two or 23 years ago, computers were

big machines that worked in big companies, and PCs that interacted with you

were new.

"This is a science-fiction moment. We now have an autonomous robot capable

of projecting ahead because she has reason to believe you'll need a certain

instrument in a moment. So she's not a power assist, she's a coworker like

R2D2. A stand-on-its-own kind of entity."

Dr. Spencer Amory, director of surgery at New York Presbyterian, described

the device as highly efficient and an excellent helper in the operating room.

Improving precision

In hospitals large and small, robots have been invading all aspects of

day-to-day routine.

At Mercy Medical Center in Rockville Centre, a robot by the name of Galileo

assists in total-knee replacement surgery.

Dr. Jan Albert Koenig, director of orthopedics at Mercy, said the robot has

enabled him to perform knee surgeries that are extraordinarily precise,

zeroing in on the exact spots where bones need to be cut.

"Before this technology, a good surgeon would be about 75 percent

accurate," Koenig said. "With the robot, we now have 99 percent accuracy."

Still, he confesses that robots have their limits: "It doesn't replace the

surgeon or the scrub team or anyone else in the OR [operating room]. But it is

a helper," Koenig said.

Handling drugs, specimens

At Winthrop-University Hospital in Mineola, a robot by the name of Walter

fills prescriptions in the pharmacy. At the Cleveland Clinic in Ohio, a robot

picks up patients' blood samples, then takes an elevator to ferry the specimens

to the lab.

Dr. Garth Ballantyne of Hackensack University Hospital in New Jersey works

with a robot that allows him to be in two places at once. According to a report

in the Journal of the American Medical Association, Ballantyne can be out of

town at a medical convention and still be able to complete hospital rounds at

home.

The robot, which has a flat-screen monitor as its head, wheels from one

patient's room to another. Ballantyne's image is beamed in. He is able to

inquire about his patient's health even though he may be thousands of miles

away.

Treat, meanwhile, a fan of Issac Asimov's "I, Robot," a tale in which an

uprising among the machines threatens humans, doesn't think robots will ever go

that far. "There are scads of innovative things going on in this field now. I

can see robots that help kids learn in school. Robots as personal companions.

More robots in hospitals. We're at the very beginning, and the future looks

very bright."

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