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“Enhanced security in telerobotic surgery”

Dr. Dipti Patil emphasized the importance of telerobotic surgery, and the security concerns it raises, in a conversation with Rahul Raj. She asserted that telerobotic surgery has changed many aspects of business and daily life. It has also improved human sensorimotor abilities, allowing them to go beyond what they are naturally capable of. It is committed to overcoming basic medical surgery challenges such as availability and accessibility. Telerobotic surgery, with the integration of cutting-edge technologies such as AI modules, is poised to open up new avenues for medical automation.
Dr. Dipti D. Patil is an Associate Professor in the Information Technology Department at MKSSS’s Cummins College of Engineering for Women in Pune. She is a registered Indian patent attorney. She has extensive experience with patent drafting and filing.
She has received several honors and awards. She was named ‘Best Teacher’ in 2020, “Best Innovation Award” in 2021 by Savitribai Phule Pune University, “Best REsearcher Award 2022′ by ISSN, “Best Professor in IT” by Dewang Mehta Education Foundation, and “Most commendable Project” by NES Innovation Awards 2020.
Rahul: Tell us about the advantages of telerobotic surgery, its awareness, and how it is changing the healthcare sector.

Dr. Dipti Patil: The ability to interact with things and surroundings remotely has been made possible by telerobotic devices, which have increased human sensorimotor capacity beyond natural competence. Teleoperated robotic systems have generated a lot of interest over the past 20 years because of their impressive advantages in both medical and non-medical applications. Focusing on medical applications, two main groups may be distinguished: teleoperated surgery and teleoperated robotic systems for rehabilitation both of which have the potential to significantly alter the way healthcare is delivered. Teleoperated surgery has been extensively researched and marketed in this regard.

However, telemedicine applications also include a variety of new remote services (whose interest increases during pandemics), such as a quick consultation or expert opinion with a particular healthcare provider, telemonitoring/diagnosis, or assistance for a specific procedure or examination over telecommunication networks.

• Telerobotic surgery has a positive prognosis for cardiac, orthopedic, and neurological crises

• Those who are restricted by geography will benefit from this.

• Offers improved working conditions for surgeons

• Improved surgical precision, better visualization, and fewer problems

Numerous areas of business and daily life have been changed by the development of telerobotic systems. Human sensorimotor abilities will be enhanced by this technology to go beyond what they are naturally capable of. 

The two main physical obstacles that this technology aims to overcome are distance and accessibility. Teleoperated surgery and telerehabilitation are just two examples of contemporary clinical uses for telerobotic systems. Due to the enormous advantages in terms of medical outcomes, there has been a significant amount of study and development in this area. Recently, telerobotic systems have been integrated with cutting-edge AI modules to improve agency sharing with the operator and create new pathways for medical automation.

Rahul: How can organizations guarantee a thorough security framework for remotely operated surgical robots?

Dr. Dipti Patil: For the protection of patients, robotic manipulation accuracy and video input to the surgeon are essential. Data integrity, a very desirable quality in a telesurgical system, is largely responsible for this accuracy. Integrity assists in telesurgery and other safety-critical applications in reaching the appropriate safety and accuracy goals. The system must offer undeniable proof in the event of any purposeful or unintentional data modification in order to demonstrate the chain of responsibility. In a similar manner, nonrepudiation is a crucial component that offers proof against the participants’ denial of involvement. These qualities would boost patients’ confidence levels, which would lay the groundwork for the success and widespread use of telesurgical technology.

A security architecture that serves as a basis for creating safe telesurgical systems. By using standard encryption and decryption algorithms, the organization can guarantee an effective security framework.

Rahul: What steps can be taken to ensure patient information confidentiality, mutual authentication, patient anonymity, data integrity, communication freshness, and mobility?

Dr. Dipti Patil: Furthermore, using the X.509 digital certificates and the patients’ biometric IDs, a secure link is created between the master and slave. A patient’s genuine identity is maintained against a dummy identity, which is never disclosed to any unauthorized parties. Implementing written policies regulates the authentication and authorization procedures. Only once an authentication session has been successful can secret parameters be shared. Similarly, it makes sure that communication data is encrypted and authenticated. The system offers several Transmission Control Protocol (TCP) and User Datagram Protocol (UDP) connections during the intraoperative phase. Additionally, the intraoperative phase communication, which includes control instructions from the surgeon console to the patient consoles and video feedback from the patient console to the surgeon console, is encrypted using the Advanced Encryption Standard (AES).

Rahul: How can a strong authentication server (SAS) and an identity management server (IDMS) be used to improve security?

Dr. Dipti Patil: In the preoperative stage of telesurgery, SAS enables the authentication of involved entities, including the surgeon console, patient console, patient, and surgeons. For the authentication process, the SAS verifies IDs from IDMS and certificates from the LCA. For various entities, LCA issues, validates, revokes, and updates digital certificates based on the X.509 standard. For additional verification, LCA creates a hierarchy with the higher level certification authority (CA).

Identity management and storage are the responsibility of IDMS. It enrolls, distributes, and updates the names of the participating organizations. Additionally, IDMS is in charge of providing anonymous patients’ biometric identities (AIDS) against those of other people. The purpose of these AIDs is to safeguard the patient’s privacy. All session security keys must be created, managed, and distributed to entities securely by the KDS. 

Rahul: How are robotic manipulation, vision systems, and communications integrated securely?

Dr. Dipti Patil: As the next stage in medical robotics, teleoperated robotic surgery systems are now being researched and developed. Teleoperated surgical robots will be anticipated to transmit video, audio, and other sensory data between surgeons and remote robots via a combination of currently existing, publicly accessible networks and temporary ad-hoc wireless and satellite networks. These technologies are expected to be utilized to give emergency medical assistance in underdeveloped rural areas, disaster zones affected by both natural and human-caused calamities, and combat situations.

Rahul: Tell us about the key trends that will influence telerobotic surgery going forward.

Dr. Dipti Patil: Telerobotic advancements will necessitate using an interdisciplinary approach to handle unique clinical and technological difficulties. Clinically oriented solutions can only be produced by involving doctors in the early stages of telerobotic system development and placing a strong emphasis on clinical research. Three fundamental enabling technologies—robotic manipulation, visual systems, and telecommunications—are linked to technological difficulties. Telecommunications networks play a significant role in the changeover of telerobotic systems. To make prototype experimental systems more functional, secure, dependable, elegant, and user-friendly while still meeting regulatory standards, they must be modified.  Doctors will need new abilities to practice telerobotics efficiently, and medical schools should take into account offering necessary training. An alternative that should be taken into account in this direction and that can be integrated with telerobotic technology is telementoring, from short distance to long distance. To ensure effective, trustworthy, and secure data transfer, it is required to adopt the most recent telecommunications technologies.

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