In a Dec 2010 blog post I described a few robot projects currently in development including a telepresence robot from HeadThere of San Francisco.

After a bit of investigation, I’ve discovered that the telepresence market is ready to explode. Besides HeadThere, there are at least five other companies in the market already and probably more coming.

Using telepresence to attend meeting remotely

As I mentioned in the Dec 2010 blog post, it is easy to imagine that having a physical telepresence robot attend a meeting can potentially provide a much better experience for both the live attendees in the room and the remote attendee controlling the robot. However, the actual experience may not match the expectation. Tom Simonite tells us in Tech. Review Jan 2011 that the initial reaction is cute, but that it wears off quickly.

In the story and in the video below, Mr. Simonite describes how having colleagues laugh during a meeting because of a bad Internet connection is an embarrassing and  stressful experience. He says,

“In one meeting, as the audio connection faltered and my voice broke into digital static, I could see the annoyance spread on my colleagues’ faces. When the connection dropped entirely, I was embarrassed that my body had become their problem, stranded in the middle of the room. When I logged back in, I was being borne across the office in someone’s arms like a child.”

Vgo

Laughing at the guy with a speech impediment. Video still from Tech. Review

Mr. Simonite was testing the Vgo, from Vgo Communications, but the problems he encountered would likely occur with any of the current generation of telepresence robots.

A less in-depth story appears in the New York Times Sep 2010. Science writer Nick Bilton used a Texai robot from Willow Garage to talk to coworkers. In general, they were uncomfortable dealing with him. And since the robot has no arms, is dependent on humans to open doors and press buttons for the elevator. An accompanying video shows how the Texai robot is successfully used at Mozilla.

texira

Serious work after the initial novelty wears off. Video still from New York Times

Another entrant in the telepresence market is the QB from Anybot of Mountain View, CA. It’s website says the product will be begin shipping in fall 2010, though it is also still taking preorders.

Anybot

QB joins a meeting. Video still from Anybot

A variety of telepresence robots, including the Vgo, Texai, and Anybot are described in the New York Times Sep 2010. The story includes a helpful chart comparing five different products.

Telepresence

Choose your telepresence robot. Image from New York Times

Using telepresence in the classroom

Another potential use of telepresence is to bring knowledge workers living in a low-labor-cost country to a high-cost country. A pilot project in South Korea will use 29  egg-shaped robots, each 1-meter tall, to teach English at elementary schools in the city of Daegu. As reported in AFP Dec 28, the Engkey robots will display a Caucasian face, but will be operated by English teachers living in the Philippines.

EngKey

The Engkey avatar. Photo from AFP

There are a lot of possible configurations for telepresence robots. For instance, check out all the prototypes on display in a trade show booth sponsored by the Electronics and Telecommunications Research Institute (ETRI) of South Korea.

engkey-others

The one on the far left almost looks real. Image from Discovery News

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The team occupying the offices next to mine is working on robots. Because the work is proprietary, I can’t reveal the details of what they are building. Plus I’m not sure what they are doing, but it looks like fun.

So instead, I’ve done some searches on the web for stories on self-propelled computing devices and found several interesting applications.

Building your own robots

The two most popular platforms for building robots are Lego Mindstorms and the iRobot Create platform. There are several open source development environments for writing controllers for robots such as TeamBots and ARIA. But of course, I am most familiar with Microsoft Robotic Developer Studio. A few sample projects using Lego Mindstorms and MSRDS is available at Coding4Fun.

LegoMindstorms   iRobotCreate

Lego Mindstorms (image from Lego) and iRobot Create (image from Wikipedia)

Creating maps using mobile sensors

Microsoft recently released a motion capture sensor for its Xbox video game console. The device, known as Kinect, uses a combination of an infrared distance sensor, two video cameras, and motion capture software to generate a 3D image of a person’s body. The data are then transmitted to the Xbox console. The Kinect has a USB port and can be attached to any computing device. Some researchers at the Massachusetts Institute of Technology’s personal robotics lab have mated the Kinect with an iRobot Create platform to create a mobile device that can generate a map of its surroundings in real-time. The robot also responds to hand signals. Check out the YouTube video (sorry no sound). The next step is to add the ability for the robot to fetch a ball and bark.

FetchiRobot

Playing fetch with an iRobot and Kinect . Video by MIT

Portable video conferencing device

Ever since the movie 2001: A Space Odyssey was released, the promise of convenient video conferencing has been just that, a promise. There are several video conferencing devices at work, but they are rarely used because you can’t really see what’s going on in the other side of the meeting. On occasion I try to use Skype to set up a video conference, but it never works quite right. I guess I’m just an incompetent Luddite. Oh well.

But a company called HeadThere wants to try another tactic. Rather than making video conferencing a way to bring a room to you, it wants to take you to the room. It has a robot called the Giraffe that consists of a monitor that sits on top of a 5-foot stalk. The monitor displays the face of the remote participant. Meanwhile, the remote participant can rotate the monitor and tilt it, which also directs the camera, speaker, and microphone. The remote user can also move the robot around as shown in the video below. (The video is over 8 minutes long, but you get the idea within the first 30 seconds).

HeadThere

HeadThere mobile telepresence robot. Video still from HeadThere

by George Taniwaki

Because of a scheduling conflict, my case has been transferred to another surgeon at University of Washington Medical Center. I’ve been asked to come in today to meet with the new surgeon, Ramasamy Bakthavatsalam. This will be my seventh appointment at the hospital since starting my evaluation.

I’ve been reading up on medical articles on live donor nephrectomy. For instance, I already know that all things being equal, left donor nephrectomy is the preferred option because the left kidney usually has less branching of the renal artery that feeds it. Having a longer straight sections makes it easier to cut the artery farther from the aorta, leaving more behind when clamping off the donor’s blood vessels after extraction. The additional length of artery on the extracted kidney also makes it easier to connect the vessels to the recipient’s blood supply. The left kidney is also easier to extract; removing the right kidney requires an extra retractor to hold the liver out of the way.

However, left donor nephrectomy is contraindicated (is not recommended) in cases where the donor’s left kidney branches into three or more arteries (which increases the chance of bleeding), or when the right kidney has cysts (the rule is to always remove the less desirable kidney and leave the better one behind), or when the right kidney is smaller than the left one (same logic as previously stated, you want to leave the bigger kidney with the donor).

In my case, the CT scan showed that my left kidney was larger than my right, which would recommend taking the right one. But my right renal artery branches very close to the aorta which would make it difficult to transplant. So which kidney should be removed?

The surgeon, whom everyone calls Dr.  Baktha, is quite certain which kidney should be removed, my right one. I asked him about the preference many surgeons have for the left kidney and the extra arteries that may require attaching if he removes my right kidney. His response was, “They (the surgical team that will transplant the kidney into the recipient) will make it work. A kidney from a live donor is a special gift and they will be happy to get it.”

I also asked him whether he will use an open, laparoscopic, or hand-assisted laparoscopic method for my surgery.

First, some background. One of the biggest advances in donor nephrectomy is the switch from open surgery (where an incision is made large enough for the surgeon to insert his/her hand) to laparoscopic surgery (where three small incisions called ports are made and robotic instruments are inserted into the patient). One port contains a retractor that holds the liver out of the way. Another port contains the cauterizing scalpel. The third holds a video camera; the surgeon views the operation using a video monitor. All of the ports are glued shut and the patient’s abdomen is inflated with carbon dioxide to allow the surgeon to easily view and access the kidney and manipulate the instruments. At the end of the surgery, a final 8cm (3inch) incision is made to remove the kidney and release the gas. The technique was pioneered at Johns Hopkins Medical Center in 1995. Laparoscopic surgery leads to less post-operative pain, smaller scars, and reduced recovery time.

There is one side effect of laparoscopic surgery. Some carbon dioxide gas can remain in the abdomen after surgery and push the diaphragm into the phrenic nerve which can cause pain while breathing. The pain can extend into the shoulder. The pain is temporary and will stop once all the gas is absorbed by the blood.

Left side laparoscopic donor nephrectomy. Video from ORLive

Originally, all of the laparoscopic instruments for donor nephrectomy were designed for left side use only. It wasn’t until a few years ago that instruments designed for right nephrectomy became available, as the video below describes.

Since right nephrectomy requires special instruments and are not performed frequently, some surgeons don’t get a lot of practice using them. Further, one of the limitations of the current generation of robots is that they don’t provide haptic feedback. That is, surgeons have difficulty sensing how much pressure they are applying to the instrument and how much resistance or tension the tissue is providing.

Conducting surgery completely by robot is a skill that takes practice. To reduce the incidence of complications during laparoscopic surgery, some surgeons recommend having a hand inside the patient to assist during right nephrectomy. As reported in J. Transpl. Jan 2010, a meta-analysis covering 9,000 patients (that included both left and right nephrectomies) shows that hand-assisted laparoscopic method provides superior results to robot-only surgery.

My surgeon says that using hand-assist is a personal preference and that he expects to use the robot-only technique in my case. I trust his judgment in this since he is one of the coauthors of a brief case article on hand-assisted right donor nephrectomy in Transpl. Nov 2003.

Right side laparoscopic donor nephrectomy. Video from UAB Health

A story in the The New York Times Feb 2010 points out that despite the many advantages of laparoscopic surgery, there isn’t much evidence that it provides better outcomes than open surgery. However, patients like it, so surgeons often promote robotic surgery. The availability of laparoscopic surgery may even encourage more people to become kidney donors says an article in Am. Surgery Oct 2004.

For more information on becoming a kidney donor, see my Kidney donor guide.

[Update1: Intuitive Surgical is the sole producer of surgical robots and markets them under the da Vinci name. Its monopoly may be hindering innovations in the surgical robot market according to Tech. Rev. Mar 2010. The story contains with a very nice video showing a repair of a blocked kidney.]

[Update2: The Wall St. J. May 2010 discusses the case of a small hospital in New Hampshire that purchased a da Vinci robot to remain competitive, but may not be performing enough operations to get surgeon proficient at using it.]

LaparoscopicWSJ

da Vinci robotic surgical instruments. Video still from Wall St. J.