Nvidia?s GTC 2010 opening day Keynote by Jen-Hsun Huang presented a breakthrough development in robotic cardiac surgery called "beating heart surgery".

Jen-Hsun Huang, CEO of nVidia introduces Dr. Michael D. Black
Jen-Hsun Huang, CEO of nVidia introduces Dr. Michael D. Black

This notable development of minimally invasive surgery [MIS] benefits patients through shortening convalescence, reducing trauma and surgery costs. The aim is to make the surgery more intuitive for the surgeon and safer for the patient.

The fact that the heartbeat and respiration represent the two major sources for motion disturbance requires the use of computer vision techniques that accurately sense the motion of the heart which are then used in a feedback control loop mechanism that synchronizes identical motion in the actual surgical elements. The heart then appears as nearly motionless to the attending physician allowing full concentration on repairing defects.

Region of Interest on a beating human heart. The image gets frozen by the GPU and the robot keeps on working on the beating heart like it is stopped, compensating for the motion using the power of the GPU
Region of interest of the human heart

Jen-Hsun introduced Dr. Michael D. Black, M.D. ? Chief, of California Pacific?s division of Pediatric Cardiac Surgery who early on in his career became intrigued with minimally invasive heart surgery in the mid-1990s. Since 1993, he has been awarded more than a dozen patents for work in the field of robotics.

Rogerio Richa, Ph. D. from LIRMM explains the development of DaVinci
Rogerio Richa, Ph. D. from LIRMM explains the development of DaVinci

Dr. Black has worked in collaboration with Rogerio Richa, PhD – The Laboratory for Computer Science, Robotics and Microelectronics of Montpellier [LIRMM], France in the development of the robotic surgical system and according to the video short of Dr. Richa presented during:

"The group has been researching technologies to perform motion compensation for beating heart surgeries. In order to avoid stopping the heart the surgeon can perform the surgical act through small holes on the patient?s thorax. Through these small incisions in the patient?s body the surgeon defines a region of interest. We?re able to estimate its motion in 3D. The robot tracks this motion and moves synchronously with the beating heart motion so the surgeon can perform his gesture as if he were operating in a virtually stable environment. The problem here is the volume of data you have to treat. The heart moves at very high speeds therefore you have to visualize the heart motion at a very high speed. In order to do that we have to acquire images at a much higher frame rate and demands a lot computational power. Till very recently we didn?t have the computational power. It is only with the GPU that this became possible because before the computational power was too expensive to achieve this. What motivates us to keep working toward such a system is the possibility of expanding motion compensation for beating heart surgery to enable surgeons to perform even more complicated procedures or procedures today that are not possible. We?re actually hoping to do something that may change medicine that will provide surgeons with more possibilities."
 
In his early operations, Dr. Black used a robot-controlled camera that mimicked the movements of a well-trained surgeon. Around 2000, his focus turned to the emerging field of telemanipulation. This "touch-free" surgical technique uses miniaturized instruments, digital cameras, and robots to perform delicate heart surgeries on a scale smaller than ever thought possible.

Since arriving at California Pacific in April 2003, Dr. Black has focused on repairing congenital heart defects in premature infants. "More than 32,000 infants are born with congenital heart disease each year in the U.S. alone," he explains. "If a mother gives birth in the second trimester and her premature infant has heart disease, there is significant potential of mortality." Dr. Black explains that this is due in part to the size of the infant and to the frequent occurrence of premature lung disease. "Clearly, when there is a need to repair a baby?s heart, we must make use of all available technologies to optimize the outcome," he explains. The smallest baby that he?s operated on for congenital heart defects weighed a mere 411 grams [0.91 lb.].

DaVinci MIS Surgical Robot
DaVinci MIS Surgical Robot

When asked to describe his vision for the future, Dr. Black explained that he wants to continue to improve haptics [sense of touch]; improved stereo for improved depth perception; the inclusion of electro and neural feedback cues. His wish is to tour a patient?s heart as if he was miniaturized and able to walk around the heart to view it?s various aspects for a more complete understanding of the heart?s condition for better and more accurate diagnosis and cure. Dr. Black also explained that the MIS beating heart procedure precluded the use of ancillary heart lung machines required for open heart surgery [This prevents many downside risks to the patient including the elimination of "Pump Head" syndrome and effects of lengthy general anesthesia].

This session was directed to point out that GPUs have lowered the cost of computations to the point where medical researchers have become empowered to apply them in their efforts to not only saving lives but also to greatly improve medical outcomes, quality of care and at a lower overall cost to society. It was a nice part of the keynote.