Military Telesurgery in cyberwarfare

(by Lorenzo Midili) To assume relevance in the context of cyberwar are the hacker attacks to telesurgery. Not surprisingly, this telematic surgery system was born in a military context, in particular in the laboratories of the US army. The first interventions took place precisely on the ships of the United States Navy, where numerous operations were carried out thanks to the support of the robot, a well-known component of telesurgery.

The surgical robot, defined as the automatic mechanical operator controlled by an electronic brain, belongs to the biomedical engineering sector and is a tool of great importance in the military field. Often, in wars, especially in battlefields, we find ourselves having to face surgical operations of a certain level and we do not always have the possibility of having specialized doctors who are able to deal with that type of operation and in that context. "chaotic". and very "dynamic"

This system of operations has given way to support, through telematic methods, different types of interventions, bringing the surgeon to operate in a serene context and with less tension, gaining enormous advantages in terms of cost savings and timely intervention of the medical staff.

However, with the introduction of this computer-electronic system, the problem concerning cyber attacks on robotic communication software has emerged. But what does this mean? A robot, like a computer or any other object belonging to the IT sector, can receive attacks from hackers where tampering with it can cause serious physical damage, invasion of privacy or even cause the death of the patient.

What is meant by an attack on telesurgery and in what form can a robot receive this attack?

We can divide the attacks into three categories; The first consists in modifying the commands sent by the operator to the telesurgery robot, in other words, the hacker cancels, creates a delay or reorders the commands sent through the control panel, thus making it impossible to control the movement of the robot. 

The second aims to manipulate the intention of the signals sent by the operator to the robot. In this case, the hacker changes the distance an arm moves or the degree of rotation of the same. The third category of attack is a complete robot takeover.

The hacker can take full possession of the machine by taking over the entire computer system and having more hacking options available. In practical terms, it can force robots to make movements that trigger an automatic stop mechanism or flood the control system to cause an attack. Denial of Service.

The latter is identified as one of the common attacks that computers can suffer, such as wiretapping, tampering, information disclosure and much more.

In addition to these types of attacks, the additional factor of physical interaction is the consequence that can occur in the field of telesurgery, compared to the computer. Taking full control of the server can result in the loss of information, while full control of a machine (robot) can cause a dangerous situation for anyone nearby.

According to a study carried out by cybersecurity experts, the simplest countermeasure to protect telesurgery systems, is the adoption of encryption for connections, as it may have a limited impact in terms of performance.

"The use of encryption and authentication has a low cost and high benefits for telerobotic surgery, mitigating many of the attacks analyzed ”.

Il Raven II, developed at the University of Washington by several scholars, it is considered the excellence for telesurgery robots. This machine is composed of a control software that runs on a single machine equipped, in turn, with another software based on open standards, communications based on the Protocol di Interoperable Telesurgery and has been designed to operate in extreme environments with greater efficiency. The threats are constantly growing but the studies on the technology are constantly developing.

The telesurgery sector needs to face new difficulties, similar to those that the information revolution had to face years ago. Undoubtedly, security in the military medical environment requires an adequate security posture to avoid further incidents.

Military Telesurgery in cyberwarfare