To Make a Robot Secure: An Experimental Analysis of Cyber Security Threats Against Teleoperated Surgical Robots (1504.04339v2)

Abstract: Teleoperated robots are playing an increasingly important role in military actions and medical services. In the future, remotely operated surgical robots will likely be used in more scenarios such as battlefields and emergency response. But rapidly growing applications of teleoperated surgery raise the question; what if the computer systems for these robots are attacked, taken over and even turned into weapons? Our work seeks to answer this question by systematically analyzing possible cyber security attacks against Raven II, an advanced teleoperated robotic surgery system. We identify a slew of possible cyber security threats, and experimentally evaluate their scopes and impacts. We demonstrate the ability to maliciously control a wide range of robots functions, and even to completely ignore or override command inputs from the surgeon. We further find that it is possible to abuse the robot's existing emergency stop (E-stop) mechanism to execute efficient (single packet) attacks. We then consider steps to mitigate these identified attacks, and experimentally evaluate the feasibility of applying the existing security solutions against these threats. The broader goal of our paper, however, is to raise awareness and increase understanding of these emerging threats. We anticipate that the majority of attacks against telerobotic surgery will also be relevant to other teleoperated robotic and co-robotic systems.

• The paper classifies and experimentally demonstrates cybersecurity threats (intention modification, manipulation, hijacking) against teleoperated surgical robots like the Raven II, showing attacks can override surgeon control.
• Experimental tests showed attacks could disrupt surgical tasks, compromising safety and efficacy, but implementing encryption and authentication significantly reduces risk for many attack vectors.
• The study highlights unique challenges, such as safety features being exploitable, and recommends revising protocol standards and implementing continual monitoring to enhance security.

Evaluating Cybersecurity Risks in Teleoperated Surgical Robotics

The paper "To Make a Robot Secure: An Experimental Analysis of Cyber Security Threats Against Teleoperated Surgical Robotics" presents a comprehensive investigation into the cybersecurity vulnerabilities of teleoperated surgical systems, using the Raven II as a case paper. As the integration of robotic systems in medical contexts grows, ensuring their security against potential cyber threats becomes critical. This paper identifies different classes of possible cybersecurity threats and proposes foundational mitigation strategies to protect teleoperated surgical robotics from malicious interventions.

The authors classify cybersecurity threats into three main categories based on how they impact surgical practice: intention modification, intention manipulation, and hijacking attacks. Intention modification involves altering a surgeon's commands, intention manipulation pertains to tampering with feedback provided to the surgeon, and hijacking involves overriding a surgeon's commands entirely. Being able to compromise a system in these ways can cause physical harm to patients, legal ramifications for surgeons, and damages to medical equipment.

A significant outcome of the research is the experimental demonstration of attack scenarios. For instance, the researchers showed that simple packet sequence manipulation could allow an adversary to control the Raven II system, thereby ignoring the surgeon's commands. Additionally, the Raven II's emergency stop (E-stop) feature, designed to enhance safety, could be co-opted by an attacker to disrupt operations and compromise safety.

The empirical tests involved engineering students executing simplified surgical tasks with the Raven II while being subjected to these attacks. Notably, these experiments underscored the potential threat since the subjects could effectively adapt to such attacks, albeit this compromised the efficacy and safety of the procedure.

The paper also evaluates existing cybersecurity measures and the extent to which they can mitigate identified threats. One notable conclusion is that implementing encryption and authentication significantly reduces the risk from many attack vectors without substantially degrading system performance. However, the authors caution against an over-reliance on existing cryptographic methods, given that the specific requirements of teleoperated systems, such as maintaining real-time feedback, may impose limitations on feasible security implementations.

Additionally, the paper highlights unique cybersecurity challenges, such as managing the tension between the safety-oriented design features like the E-stop and the potential for these features to be exploited as vulnerabilities under adversarial conditions. Recommendations for advancing the security of teleoperated surgical systems include revising protocol standards like the Interoperable Telesurgery Protocol (ITP) to ensure robust packet processing and employing continual monitoring to detect unusual network activities.

Overall, this paper contributes significantly to the discourse on the cybersecurity of teleoperated robots used in medical applications. It underscores the nuanced balance required between ensuring security and maintaining operational integrity in high-stakes environments. Future work should focus on further refining cryptographic approaches that address real-time requirements and developing adaptive security frameworks that can reconcile safety features with cybersecurity needs. This research provides a pivotal foundation for ongoing efforts to safeguard the integration of robotic systems in sensitive applications such as surgery, where the stakes of failure are particularly high.