Yulun Wang uses miniaturized robotics to help surgeons performs minimally-invasive procedures.
by Marc Star

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esop move left. Aesop move in. Aesop move right. Stop." A black robotic arm positions itself in response to the surgeon's voice commands. At the end of the arm, a thin, silver tube juts through the patient's belly. His organs are displayed on a TV monitor while the surgeon operates two foot-long scissor-like instruments which also protrude into the patient.
     Thanks to the AESOP (Automated Endoscopic System for Optimal Positioning), he is now a three-armed surgeon--and a very accurate one.
"I eventually latched onto this concept of a scope-manipulating robot that would add capabilities to the surgeon to really give that surgeon a third arm."
     In a perfect marriage of necessity and invention, Yulun Wang found a surgical problem and used his engineering and robotic background to solve it. He didn't invent laparoscopy, but his ingenuity provided a more efficient way to perform the technique.
     Laparoscopy is a minimally invasive surgical method which requires only three small one-inch cuts to be made in a patient, as opposed to a six-inch incision across the abdomen for gallbladder removal surgery, for example. The procedure is less painful for the patient who often can return home the next day.
     Before AESOP, a second person was needed to hold the camera, which is inserted into a patient during the procedure. But the surgeon was hampered by communication difficulties involved with having a second person hold the camera. Imagine trying to paint while someone else holds up the canvas for you. In surgery, your tools are attached to a sometimes unsteady camera arm. A three-hour or so surgery can become a grueling operation, trying to watch a shifty picture and direct a surgical operation at the same time.
     Then there's the frustration involved in barking out commands: "Left, down, move in a bit. No, I said left!"
     Computer Motion Inc.'s AESOP solves all that, and gives the surgeon even more functionality than ever before.
     In purely mechanical terms, it solves the counter-intuitive problem of having to move the camera arm down whenever the surgeon wants the screen shot to pan up. When the surgeon tells the robot to pan up, it reacts in accordance with the monitor. Tell AESOP to remember its position and it will return you there on command. And it allows surgeons to perform solo surgery, certainly a blessing in today's cash-strapped health care market.
     Wang demonstrates the procedure on a fake cadaver. Its plastic insides show up on the nearby video monitor. The first generation AESOP, the 1000, uses a foot control, which Wang ably operates. Then he dons the headset of the 2000. "Welcome to AESOP," the robot greets in the standard computerized voice. Warm, yet metallic. The robotic arm responds gracefully to Wang's voice commands.
     Wang lays out some history as he maneuvers around the patient's vital parts. "Laparoscopy hit a real step function in 1989 with the development of the laparoscopic gall bladder procedure," he says. "600,000 of those are done a year in the U.S. alone. That one procedure created a multi-billion dollar market."
     In 1991, Wang and his associates were banging their heads against the wall looking for a product opportunity. Wang had already created a new 3-D chip architecture specialized in doing vector calculations. The architecture allowed an advanced manipulation of the mathematical equivalents of positions, velocities, accelerations, forces and torques--calculations necessary for 3-D graphics and robotics. All well and good, but where exactly would it be used? Computer Motion searched the market place.

     When Wang saw how medical costs were rising, when he saw that health care was predicted to be 20% of the GNP by the year 2000, he knew he'd found his market. "I said 'Holy cow, that's where all the money's going,'" says Wang.
     "I started talking to friends I knew who had taken the route of medicine. I learned about laparoscopy. I eventually latched onto this concept of a scope-manipulating robot that would add capabilities to the surgeon to really give that surgeon a third arm."
     The FDA only recently approved AESOP 2000, the voice-controlled version, at the end of last June. It is the first voice-controlled medical robot on the market, the culmination of over ten years of technological development, begun during Wang's Ph.D. at UC Santa Barbara. Not a doctor--and without any previous medical background--Wang now leads the surgical room into the future.
     "Don't take a picture of that," Wang cautions. "That's not for the public yet." That is Wang's next step in turning the operating room into something a little more user-friendly for surgeons.
     Much of minimally invasive surgery requires the sewing of tissue done from a position outside of the body. It's a surgical technique that requires an incredible amount of dexterity and one which most surgeons won't and can't perform. Now, Computer Motion is transforming a surgeon's minimally invasive shears into robotically controlled instruments. The shears are activated by the surgeon, but inside the body, they move with the steadiness and precision one would expect from a robot. Even Wang is able to maneuver a needle no bigger than a standard staple through the fake organ and back out. And he's no doctor.
     He is, however, a surfer, and like any good surfer worth his wax, he stresses the importance of the "quality of life." Computer Motion is located in Goleta, California for a very good reason: the weather's nice and the surf is usually up. Isla Vista, one of the Seven Party Wonders of the World, is just to the west, on the water.
     More importantly, however, is the company's proximity to UC Santa Barbara. That's where Wang found Bob Duggan, the company's first major source of capital, outside of two Small Business Innovative Research grants from NASA and the National Science Foundation. And a good portion of the people working for Wang at Computer Motion were fellow Ph.D.'s studying at UCSB's Center for Robotics Systems and Microelectronics. PAGE 2

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