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The cutting edge

Hermes, insufflate,” commands Constantine Frantzides, eyes fixed on the liver gingerly clenched between his forceps. His assistant, Hermes—a state-of-the-art surgical computer trained to follow a repertoire of voice commands—chirps in compliance and inflates the patient’s body cavity with carbon dioxide, allowing Frantzides to repair the hiatal hernia causing the patient’s heartburn.

Like many surgeons today, Frantzides, professor of surgery at the U of C and chair of the division of surgery at its Louis A. Weiss Memorial Hospital, relies on minimally invasive, or laparoscopic, surgical techniques to reduce the pain, risks, and extended hospital stays of conventional surgery. But his integration of technology like Hermes takes the advantages of laparoscopic surgery a step further.

Building his career on laparoscopic techniques—eight of which he pioneered—Frantzides can perform procedures that previously required incisions of up to 12 inches through just a few quarter-inch slits in a patient’s abdomen. A camera inserted through one slit allows Frantzides to watch on a monitor above the patient as he uses special tools inserted through the others to cut, cauterize, suction, and suture.

The centerpiece of Frantzides’ futuristic operating room is Hermes. The device was named for the Greek gods’ messenger by its developer, Computer Motion, for its role in carrying out a surgeon’s instructions and alerting staff to the status of the operation.

Before an operation, Frantzides inserts a computer record of his voice patterns into Hermes, which descends from the ceiling on its own power-assisted boom. Other instruments and monitors in the room, dubbed an endosuite, can also be pulled down from the ceiling for use or left retracted for storage.

Able to decipher Frantzides’ mild Greek accent, Hermes allows him to more seamlessly direct surgical procedures, providing audio feedback when it completes a task. Hermes can perform a number of actions that would otherwise require the surgeon to turn away from or lean across the patient to adjust controls manually.

Speaking into a headset, Frantzides can ask Hermes to inflate the body cavity, increase or decrease the intensity of light illuminating the cavity, or take a snapshot of the area under investigation, all while his eyes are fixed on the monitor above.

Frantzides plans one day to use a slim-profile monitor mounted on his office wall to coach a surgeon across the country through an operation. He also envisions an operating room where the surgeon uses motion- and pressure-sensitive gloves to manipulate sterile robotic extensions that perform surgical procedures on the patient. Though a strong advocate of advanced technology in the operating room, Frantzides still believes that technology will never render the surgeon obsolete. “There’s always a boundary,” he says. “The surgeon will always control the operation.”—M.D.B.

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