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Networking Medicine

The Network Revolution Needed For Remote Surgery (thestack.com) 103

An anonymous reader writes: IEEE researchers are proposing new standards for haptic codecs over software-defined 5G networks in order to achieve the ambitious 1ms latency and reliability required for the 'tactile internet'. It's a trivial consideration when hugging chickens over a network, more serious for applications of telesurgery, and a proposed leap in network quality that seems likely to yield benefits for general data streams as well.
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The Network Revolution Needed For Remote Surgery

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  • Do Not Want (Score:2, Insightful)

    >> more serious for applications of telesurgery

    Do not want. If I'm under the knife, I'd like a doctor present in the room, not some dude with a "medical degree" dialing in from the other side of the world while moonlighting from his IT helpdesk job.

    • Re: (Score:1, Funny)

      by Anonymous Coward

      Wow what a sense of entitlement. You expect a pro to be in the room during your surgery? Check your privilege shitlord. There are plenty out there who have no access to such surgery at all.

      • I am seeing a lot of the "shitlord" word going around recently... perhaps I am just noticing it more. But it still has a novelty factor that makes me chuckle every time I see it used.

        Thanks ;)

        • by Anonymous Coward

          I am seeing a lot of the "shitlord" word going around recently...

          The people that use that word together with the word "privilege" are usually really, really stupid. Just useless human beings. Watch out for them, they can be bat-shit crazy too.

          • by Fwipp ( 1473271 )

            You know that they're all anti-SJ trolls, right? I'm an SJW, a commie, and a tranny, and I can't recall anytime I saw anyone seriously say "shitlord" since, like, 2012. But for some reason all the anti-SJ people think that's how we talk. It makes them all really easy to spot, to be honest. They're also usually gonna say "privilege" or "trigger" in a way that doesn't make any sense, or claim to be, idk, spatulakin or something.

        • Probably just a typo of "shitload". That's how these things get started.
      • by Anonymous Coward

        I feel the need to point out that in your "holier than thou" entitlement rant, what makes you think that if an area can't afford to have a surgeon around, they're going to be able to afford this equipment, both the purchase (which may be donated) and the upkeep (which people donating tend to forget about)? Throw in unexplainable transient issues in technology, yeah, I don't want my surgeon to teleconference in. I don't think it's fair to think the poor should be grateful for it either. And I'm speaking f

        • Hell, I just try to remotely control my computer from a distance and it will suck ass at random moments in time.

          Some days I can load up a citrix desktop from across the country, RDP to a machine back in my state from that citrix session, and use it so well I almost forget I am remote (although for some reason, Chrome is barely functional over this connection...lags like hell, even if it is just in the background and not the active window ...IE works fine). Yes, I know a Remote Desktop Gateway Server woul

      • by x0ra ( 1249540 )
        I doubt they'll either be in an area with low latency internet...
    • Telemedicine is for people who would otherwise lack access to care.

      • Telemedicine is for people who would otherwise lack access to care.

        Such as: in the ISS, Antartica, on Mars...

        • getting 1ms latency to mars to allow this would be quite an amazing feat and would rewrite our knowledge of physics.

          • Point being, telemedicine to Mars has value, and will never have 1ms latency (unless we do rewrite the laws of physics.)

            • Yeah there probable is value. However, best case scenario there is something like a 30 minute round trip for communications to mars, so for a medical robot to have value in such an environment it would likely need to be able to do most procedures autonomously. with the doctor just checking on the outcome after it has been completed.

          • Getting 1ms latency from ANY hospital (on soil) to anywhere (on soil or non-floating ice) in Antarctica would also require a re-write of physics. The Drake Passage is about 3 times too wide for that to be possible.
      • by Greyfox ( 87712 )
        So, Like, Missouri?
    • The interesting question is whether allowing surgeons to telecommute makes you more or less likely to be chopped open by some hack.
      On the minus side, we've certainly all experienced the fact that when the call center gets off shored it is because nobody gives a damn and a cheaper labor force can do a bad job for less. On the other hand, there's the old quip about 'what do you call a med school grad in the bottom ten percent of his class? Doctor.' and the fact that only having access to on-site talent means
      • The interesting question is whether allowing surgeons to telecommute makes you more or less likely to be chopped open by some hack.

        Now that we are planning on making surgery part of the Internet of Things, it looks like the transition is just about complete. Hopefully the process will be 100 percent secure.

        A side issue is that those really poor backwaters you refer to will be hard pressed to afford the machinery, and of course the personnel to run it calibrate it, sterilize it, and keep it in working order.

        And I'm really curious about just what this is supposed to free up. If I might, I can relay the experience I had just a few wee

        • It is difficult to imagine 'telemedicine' being competitive for elective operations, at least until the robots are so advanced that the human on the other end of the line is increasingly redundant. It becomes more theoretically interesting if the patient can't be safely moved or the procedure can't be safely delayed. I don't know what proportion of operations are actually that urgent. Some are, certainly; but those may be more dramatic than they are common.
    • by dissy ( 172727 )

      [Transcript of operator overheard in surgery control operations]

      OK lets just cut this open here. Now spread these ribs open. Yes that's it, one more cut and clamp and...

      Uh oh sir, it looks like your Oracle licencing isn't up to date. I'm contractually bound not to support this setup as-is. You'll need to contact your account representative first.

      I'll just drain this general anesthetic out of you lickity split and let you go do what you need to do, then please call our main number back and reference ticke

    • If I'm under the knife, I'd like a doctor present in the room, not some dude with a "medical degree" dialing in from the other side of the world while moonlighting from his IT helpdesk job.

      If you got appendicitis in Antarctica, I wager you'd be happy to have a surgeon fixing it remotely (assuming the technology was up to the task) than the local GP with no surgical qualifications.

      • You might be mis-remembering this :

        In about 1970 a Russian base had a case of appendicitis after going into lockdown because of weather. The "GP" (who was not your average GP, but one carefully chosen for resourcefulness and experience, because this was a base going into a winter lockdown with temperatures going down to about -90degC ; not your average GP) examined the patient, worked through the options, tried antibiotic treatment, but eventually had to concur that it''s appendicitis. And operation is the

    • I don't think anybody is suggesting telesurgery is going to be the normal way of doing things, or that you would routinely outsource it.

      But if you're in some remote place and need critical care, it makes sense. Oil rigs or other remote and dangerous places make sense.

      AFAIK, this is real surgeons trying to solve real problems, not someone trying to come up with an outsourcing model.

      But if you start bleeding out, the surgeon needs to respond as fast as he would if in the same room to fix it. And I think the

  • 1 ms ping time (Score:5, Interesting)

    by wendyo ( 168574 ) on Monday January 04, 2016 @06:48PM (#51238121)

    1 ms of ping time at the speed of light only gives you at best 150 km.

    • by Anonymous Coward

      With a robot between the surgeon and the patient, the ping requirement might not be so strict. Open heart surgery without stopping the heart while the surgeon can operate on the organ as if it would have been stopped should be one of the more demanding and amazing applications of the surgical robots. Human reaction time is lot longer than the 1 ms, so it comes down to the quality of the surgeon-robot-patient interfaces.

    • 1 ms of ping time at the speed of light only gives you at best 150 km.

      Pfffft. Amateurs.

    • And to get that we'd need to replace all that laggy legacy fiber with a series of tubes pumped down as close to vacuum as possible, run perfectly straight between nodes. That might get costly.
    • Re:1 ms ping time (Score:5, Informative)

      by JoeMerchant ( 803320 ) on Monday January 04, 2016 @09:09PM (#51239019)

      the speed of light = 299 792 458 m / s

      Or, 299.792458 km / ms

      Well done, sir - round trip time of 1ms happens at 93.14 miles, or less in slower medium (~60 miles in glass). For example, for visible light the refractive index of glass is typically around 1.5, meaning that light in glass travels at c / 1.5 200000 km/s; the refractive index of air for visible light is about 1.0003, so the speed of light in air is about 299700 km/s (about 90 km/s slower than c). https://en.wikipedia.org/wiki/... [wikipedia.org]

      • by Anonymous Coward

        Not only that, but in the optical fiber, the photonss travel a zigzag path that probably adds at least 50% to the travel distance.

  • When I'm getting a surgery, I don't want it interrupted because a Comcast router craps out or a neighbor starts torrenting 4k videos.

    I mean, I can understand the need if there were only a few surgeons in the world, but I live in a city and I look around and there's lots of surgeons. Also, in small number of cases where a rare specialty surgeon is needed, airplane tickets are cheaper than telerobotic equipment.

    • by epyT-R ( 613989 )

      They want to do with surgeons what they already did to IT workers.

    • by AHuxley ( 892839 )
      The idea is a nation has real optical connections between its large national teaching hospitals and a more remote hospital in a distant regional area.
      Local staff can set the equipment up, prep the patient as needed but the expert team is in a main city.
      Bandwidth, data sets, networking is then less of an issue as the connection is the optical link. For that a nation would have to invest in optical end to end. The issue with wireless is still the physics of real bandwidth, sharing, number of users, network
    • I'd like to live in a world where anyone competent to be a surgeon is allowed to study and become one.

      A big part of the cluster---- that is medical care in the U.S.A. starts with the A.M.A. and their restrictions on entry to medical school.

    • airplane tickets are cheaper than telerobotic equipment.

      Um, no, they're actually not. Airplane tickets _today_ are selling you non-sustainable joyrides on non-renewable fossil fuel. Each trans-oceanic flight burns more fuel than the weight of the passengers and their baggage. Telerobotic equipment is reusable and operated by the transfer of information, not the transfer of bags of meat - information moves much much more cheaply than people do.

    • by KGIII ( 973947 )

      Pfft... What can possibly go wrong with this? They've got thi ^%$(&))^[lost carrier]

  • by namgge ( 777284 ) on Monday January 04, 2016 @06:53PM (#51238161)

    Hmm. If a 1ms latency is what's needed, the speed of light through the network limits the separation of the patient and surgeon to about 100 miles or so.

    If a truck filled with tapes beats the bandwidth of the fastest network, I guess an ambulance with the patient in it is the metric that needs to be to beaten here.

    • by Anonymous Coward

      Hmm. If a 1ms latency is what's needed, the speed of light through the network limits the separation of the patient and surgeon to about 100 miles or so.

      Actually it's about 1/3rd of that. "The Speed of Light" as most people call it is really the speed of light in a vacuum. Not only does light move slower through a physical medium (like glass or plastic fibers) but in optical networks the light does a lot of bouncing around... it's not going in a straight line.

      I think the idea they're getting at is, particularly in dense urban areas, having a central medical office and then having smaller, remote surgery rooms located within about 15 to 20 miles of the main

      • You're right about the realities of latency.

        Personally, the 1ms number sounds like it was pulled out of somebody's nether regions.

        If I play a single 100us pulse through a speaker, you hear it as a click. If I play two pulses, you hear two clicks - until they are about 2ms apart - at less than 2ms the clicks begin to merge and by 1.5ms they are basically indistinguishable from a single click.

        Joe Supertwitch the surgeon says he can't frag that lesion perfectly unless he's got less than 1ms lag time, Joe Supe

        • by Bengie ( 1121981 )
          Takes about 5ms for a signal to get from your brain to your hands. I'm sure the 1ms is taking about something else, like jitter.
  • by The-Ixian ( 168184 ) on Monday January 04, 2016 @06:56PM (#51238183)

    Ok, one question, probably stupid.

    Is 1ms latency even physically possible if the 2 nodes are on opposite sides of the world?

    Or are they talking about "within the same city" kind of network?

    Also... 5G? Over-the-air? Wireless is not my first thought for medium when I think of low latency...

    • Also... 5G? Over-the-air? Wireless is not my first thought for medium when I think of low latency...

      wireless is not my first medium for a stable connection that won't crap on while he's cutting you up...

      • by Melkman ( 82959 )

        Using fiber or copper on the other hand reduces the maximum distance with 30% due to the slower propagation of signals in those media.

    • by jon3k ( 691256 )
      Speed of light is 186 miles per millisecond, so no, not possible. Even if you could transmit it in a perfectly straight line in a vacuum you couldn't get it around the world in 1ms.

      By the way, Google will do the conversion for you automatically, just search for "speed of light in miles per millisecond" or something along those lines.
  • until Comcast craps out. How far can they take this last mile over-subscription? What carrier would take on the liability of a patients life based on their QoS. Verizon would, but then they would end up suing the patient's family in the end.
  • by tlambert ( 566799 ) on Monday January 04, 2016 @07:01PM (#51238239)

    Use a leased line.

    Problem solved.

    Your max is 100 miles anyway.

    • Use a leased line.

      Problem solved.

      Your max is 100 miles anyway.

      Why would you think that a leased line is immune to noise and other sources of data loss? There is absolutely no physical difference in lines. Yes, there is no congestion, but that is far easier to deal with than line noise, cosmic rays and backhoes.

      • Use a leased line.

        Problem solved.

        Your max is 100 miles anyway.

        Why would you think that a leased line is immune to noise and other sources of data loss? There is absolutely no physical difference in lines. Yes, there is no congestion, but that is far easier to deal with than line noise, cosmic rays and backhoes.

        What about intentional denial of service attacks or take-overs in the middle of your heart surgery because someone really, really doesn't like something you posted in your Facebook status, such as "no longer in a relationship", or they found out you were the idiot who posts the "Moo" thing on Slashdot, or they found out you're the person who calls them from Florida and blows the cruise ship horn in their ear in order to scam money from them, or they find out you're the guy who signed off on their IRS audit?

        • These are not the sort of issues that most are concerned with, though they are legitimate. As far as spying goes, leased lines are no more immune from targeted attacks (specific wire taps) than any other connection, though they do avoid mass data collections (e.g. GCHQ data sweeps).

          The point of the article is that common issues with "normal" networks such as congestion and data loss need magical networking. My point was that leased lines are not a solution to the general problems that are most likely to cau

  • by dohzer ( 867770 ) on Monday January 04, 2016 @07:07PM (#51238287) Homepage

    "Telesurgery" and "5G networks" should never be mentioned in the same story.

    • You beat me to it. The only possible reason for a 5G network to be involved with telesurgery, would be to serve as a backup to the backup wired network, which itself is a backup to the primary wired network.
      • You beat me to it. The only possible reason for a 5G network to be involved with telesurgery, would be to serve as a backup to the backup wired network, which itself is a backup to the primary wired network.

        You have to look at the bigger picture. This is another version of what I call BPL syndrome. BPL was Broadband over Power Line, which promised to bring you the internet without running extra cables - right from a power socket. Problem was, it delivered DSL speeds at best, interfered with amateur radio and trans polar commercial airline flights and could be interrupted easily by kids with Citizen Band radios. And it might just accidentally deliveras much as a couple KV to your household wiring in the efvent

  • First of all, remote surgery is stupid. Having a remote doctor advising while a local doctor does the procedure is all fine and good, but having some expensive robot do the work that a remote doctor tells it to do is dumb for a variety of reasons, the most obvious being cost. How many hospitals would waste money on a remote surgery robot rather than hiring more doctors or better doctors...

    Assuming that remote surgery robots ever did become popular, why the fuck would they even consider connecting them over

    • How many hospitals would waste money on a remote surgery robot rather than hiring more doctors or better doctors

      A few years ago I read an article about hospitals that bought telesurgery equipment to compete with other hospitals in the same area. So it apparently happens.

      The punchline? The telesurgery equipment sits idle much of the time.

    • Imagine that we re-brand the 'expensive robot' as a 'turnkey managed surgery solution' or a 'patient outcome appliance' and ask your IT minions about whether HQ likes capital costs or expensive human resources less...
    • How many hospitals would waste money on a remote surgery robot rather than hiring more doctors or better doctors...

      You probably live in a decent-sized city with more than one very good hospital.

      Think instead of some very remote place, like Antarctica.

  • by David_Hart ( 1184661 ) on Monday January 04, 2016 @07:19PM (#51238339)

    Yes, remote surgery would be nice but obviously has limitations.

    My thought is that automated surgery would be better...

    Perhaps remote surgery is a necessary stepping stone needed for machine learning to get us to automated surgery.

    • How about we start with automated autopsy?

      After automated butchery - I gather that many armies are gearing up for that.

      Oh, hang on. Looking down thread, an AC says :

      by Anonymous Coward on 2016-01-05 4:08 (#51239739)
      Physics dictates you aren't getting 1ms latency outside of a very, VERY short distance.
      Shoot these snakeoil salesmen right now.

      The AC is right - for "short distance" under 300km (one way or round trip, depending whether you're talking about one-way or round-trip times). But I think he's foun

  • Would you trust ANY ISP to deliver your surgery packets?

    I sure as hell would not.

  • Not because there is any way in hell I'm going to let a surgeon 100 miles away get a knife anywhere near my Tender Bits (tm), but because the fallover effects mean I can play a Call of Duty game with sub 250ms lag.

    Just think, good as I am now with CoD, how much better would I be with decent lag times?
  • Long before tele-surgery becomes common enough to be accepted, the use of tele-sex will have driven this low-latency, haptic feedback systems. Unless you buy the vagina-dentata [wikipedia.org] attachment for your fleshlight, or the woman on the other end uses the "come like Superman" attachment ("faster than a speeding bullet" : that'll be a rail gun ejaculator then. Messy!), then the worst that's going to happen is that you need to remove the batteries and vent the hydraulics.

    And no one has said "tele-dldonics" yet. Sham

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