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Short Circuit: MD Anderson Robots Provide Safety in the 21st Century

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dexter copy.jpgBy John Chattaway, MD Anderson Staff Writer

Robots. The word conjures images of science fiction characters from movies such as The Terminator, Star Wars or Transformers.

But those characters actually are androids, forms of human-like artificial intelligence. Robots are machines that, when programmed or operated by a person, can perform specific tasks.

At MD Anderson, we're using them to improve the safety and efficiency of our care.

"I'll be back"... with your medication
Pharmacy has been taking advantage of robot technology since 1998.

The first outpatient robot was installed in the outpatient pharmacy on Floor 2 of the Main Building. Now, all three outpatient pharmacies use the ScriptPro SP 200 prescription dispensing system.

Our outpatient pharmacies dispense approximately 1,300 prescriptions a day. According to Lori Bertrand, manager, Pharmacy Operations, the robots account for almost 55% of our prescription volume. The SP 200 robot can fill and label 150 prescriptions an hour. "It would be closer to 95% except that chemotherapy, narcotics and investigational drugs can't go into the ScriptPro robot," Bertrand says.

If you walk through one of the outpatient pharmacies, you might not notice the ScriptPro robot. It looks like a big, glass bookcase attached to a file cabinet, computer and conveyer belt. But instead of books behind the glass case, there are 200 cells, each filled with a fast-moving drug.

"The robot is easy to use," Bertrand says. "When an order comes in for the ScriptPro, it uses barcodes to locate the right cell. A robotic arm holds an empty vial, while lasers are used to count and fill the appropriate dose. The robot then prints and labels the vial and delivers it, uncapped, down the conveyer belt for a technician to check."

It's showtime for Dexter
In the inpatient pharmacy on the first floor of the Main Building, you'll find "Dexter," the McKesson ROBOT-Rx automated medication dispensing system.

Similar to the ScriptPro robot, Dexter's job is to fill unit dose medications for inpatients. Its appearance, however, is much different. Dexter is a large, octagon-shaped room with a robotic arm in the middle. The arm can rotate 360 degrees and pull medications off the walls.

"When an order comes in, Dexter uses a barcode system to locate the drug, retrieve it, label an envelope and drop the drug into the envelope," says Phuc Dang, manager, Pharmacy Operations. "Dexter then slides the envelope down a conveyor and into a holding bin. Dexter dispenses 850 doses a day -- 8% of inpatient's non-sterile doses -- and can hold about 450 line item drugs."

"Use the force!"... with just a flick of the wrists
Renaissance artist Leonardo da Vinci once said, "Simplicity is the ultimate sophistication." If he saw Intuitive Surgical's da Vinci Surgical System, he might change his mind.

The da Vinci system is a state-of-the-art surgical platform used for minimally invasive surgeries. The system comprises a surgical console that controls the robot, the patient-side unit with four robotic surgical arms, and a video tower that includes the system processors. Our surgeons use three of these mobile robots, fondly nicknamed, "Deuce," "The Beast" and "The Twins." Deuce and The Beast are wheeled to different operating rooms as needed, while The Twins is a dual-console system located in Operating Room 31.

Here's how the system works: A surgeon sits at the console and looks into a 3-D video display. The video feed is from a 3-D high-definition camera located on the robot. The surgeon places his or her hands into the fingertip controls, which direct the robotic arms. The controls mimic the movements of a surgeon's wrists, while eliminating the natural tremors that occur in human hands.

The feed from the camera also is displayed on the video tower screen so the entire surgical team can see what's happening. The touch screen allows notations to be seen by the surgeon to enhance communications.

"What makes The Twins' dual-console system unique is that it allows for collaboration and teaching between surgeons," says Nadine Turner, nurse manager, Main Operating Room Nursing. "It's like a driver's education car with a wheel and pedals on the passenger side. There are two consoles that can control the robot, and control can be passed between surgeons."

Surgery has been using the da Vinci Surgical System since 2006. Initially, it was used only for urologic procedures, but now it's used for most types of surgery, excluding brain and arthroscopic surgeries.

"The main benefit of using the robots is to provide a quicker recovery time for the patient because it's more precise. So the incisions are smaller, and there's less blood loss and trauma around the tissue," Turner says.

Related story
Short Circuit: MD Anderson Robots Provide Safety in the 21st Century Part II

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