How augmented reality could change the future of surgery | Nadine Hachach-Haram

Translator: Carlos Calo Romeu Reviewer: Mario Cal

According to the theories of human social development,

De acordo coas teorías sobre o desenvolvemento social humano,

we're now living through the fourth great epoch

estamos vivindo na cuarta grande época

of technological advancement,

do avance tecnolóxico,

the Information Age.

a Era da Información.

Connectivity through digital technology is a modern miracle.

A conectividade mediante tecnoloxía dixital

é un milagre moderno.

We can say it has broken down barriers of time and space which separate people,

Pódese dicir que rompeu os límites do espazo e do tempo que separan a xente,

and it's created a condition for an age

e que posibilitou unha era na que as ideas se poden compartir libremente.

where information, ideas can be shared freely.

[Presenza de imaxes médicas sensibles]

But are these great accomplishments in digital technology

Pero son estes grandes avances en tecnoloxía dixital

really the endgame in terms of what can be achieved?

o verdadeiro punto e final de ata onde podemos chegar?

I don't think so,

Non o creo,

and today I'd like to share with you

e hoxe quero compartir con vós

how I believe digital technology can take us to even greater heights.

como creo que a tecnoloxía nos pode permitir chegar máis alá.

I'm a surgeon by profession,

Traballo como cirurxiá,

and as I stand here today talking to all of you,

e mentres estou aquí, falándovos a todos vós,

five billion people around the world lack access to safe surgical care.

cinco mil millóns de persoas carecen de coidados cirúrxicos seguros.

Five billion people.

Cinco mil millóns de persoas.

That's 70 percent of the world's population,

Iso vén sendo o 70 por cento da poboación mundial,

who according to the WHO's Lancet Commission

que, segundo a Comisión Lancet da OMS,

can't even access simple surgical procedures

non pode acceder nin a tratamentos cirúrxicos sinxelos

as and when they need them.

onde e cando o necesite.

Let's zoom in on Sierra Leone,

Ímonos fixar en Serra Leoa,

a country of six million people,

un país con seis millóns de habitantes,

where a recent study showed that there are only 10 qualified surgeons.

onde un estudo recente demostrou que só hai 10 cirurxiáns cualificados.

That's one surgeon for every 600,000 people.

Iso é un cirurxián por cada 600 000 habitantes.

The numbers are staggering,

As cifras son inquietantes,

and we don't even need to look that far.

e nin necesitamos mirar tan lonxe.

If we look around us here in the US,

Se miramos aquí mesmo, nos Estados Unidos,

a recent study reported that we need an extra 100,000 surgeons by 2030

un estudo afirmou que necesitaremos 100 000 cirurxiáns máis de aquí a 2030

to just keep up with the demand for routine surgical procedures.

só para atender a demanda de procedementos cirúrxicos rutineiros.

At the rate that we're going, we won't be meeting those numbers.

Ao ritmo actual, non imos chegar.

As a surgeon, this is a global issue that bothers me.

Como cirurxiá, este é un problema mundial que me preocupa.

It bothers me a lot,

Preocúpame moitísimo,

because I've seen firsthand

porque teño comprobado de primeira man

how lack of access to safe and affordable healthcare

como non contar cun servizo sanitario seguro e accesible

can blight the lives of ordinary people.

pode arruinar a vida da xente.

If you're a patient that needs an operation

Se es un paciente que necesita operarse

and there isn't a surgeon available,

e non hai un cirurxián dispoñible,

you're left with some really difficult choices:

tes que afrontar unha decisión moi difícil:

to wait, to travel,

esperar, viaxar,

or not to have an operation at all.

ou directamente non operarte.

So what's the answer?

Así que, cal é a resposta?

Well, part of you are carrying some of that solution with you today:

Algúns de vós tedes parte da solución aquí mesmo:

a smartphone, a tablet, a computer.

un móbil, unha tableta ou un ordenador.

Because for me,

Porque para min,

digital communications technology has the power to do so much more

a tecnoloxía da comunicación dixital ten o poder de facer máis

than just to allow us to shop online,

que simplemente permitirnos comprar en liña

to connect through social media platforms and to stay up to date.

ou estar ao día do que pasa nas nosas redes sociais.

It has the power to help us solve some of the key issues that we face,

Ten o poder de axudarnos a solucionar algúns problemas críticos,

like lack of access to vital surgical services.

como a inaccesibilidade a servizos cirúrxicos vitais.

And today I'd like to share with you

E hoxe quero compartir con vós

an example of how I think we can make that possible.

un exemplo de como creo que podemos facelo realidade.

The history of surgery is filled with breakthroughs

A historia da cirurxía está chea de fitos

in how science and technology was able to help the surgeons of the day

en que a ciencia e a tecnoloxía axudaron aos cirurxiáns do momento

face their greatest challenges.

a superar calquera reto.

If we go back several hundred years,

Se retrocedemos no tempo uns centos de anos,

an understanding of microbiology

entender a microbioloxía

led to the development of antiseptic techniques,

provocou o desenvolvemento de técnicas antisépticas,

which played a big role in making sure

o que tivo un gran papel

patients were able to stay alive postsurgery.

na supervivencia dos pacientes despois dunha operación.

Fast-forward a few hundred years

Avanzamos uns centos de anos

and we developed keyhole or arthroscopic surgery,

e conseguimos desenvolver a cirurxía artroscópica,

which combines video technology and precision instruments

a cal combina tecnoloxía de vídeo e instrumentos de precisión

to make surgery less invasive.

para facer a cirurxía menos invasiva.

And more recently, a lot of you will be aware of robotic surgery,

Algo máis actual e coñecido é a cirurxía robótica,

and what robotics brings to surgery is much like modern automated machinery,

e como esta aporta á cirurxía as calidades das máquinas modernas:

ultraprecision,

ultraprecisión,

the ability to carry out procedures at the tiniest scales

a capacidade de realizar intervencións en escalas diminutas

with a degree of accuracy that even surpasses the human hand.

cun nivel de precisión que incluso supera a do ser humano.

But robotic surgery also introduced something else to surgery:

Pero, a cirurxía robótica engadiu algo máis á cirurxía:

the idea that a surgeon

a idea de que un cirurxián

doesn't actually have to be standing at the patient's bedside to deliver care,

non ten que estar ao lado do paciente para atendelo,

that he could be looking at a screen

senón que podería estar mirando unha pantalla

and instructing a robot through a computer.

e controlando un robot por ordenador.

We call this remote surgery.

Chamámoslle a isto cirurxía remota.

It is incumbent on us

É da nosa incumbencia

to find solutions that solve these answers in a cost-effective and scalable way,

encontrar solucións que respondan dun xeito rendible e escalable,

para que todo o mundo, tanto ten onde se atope,

so that everyone, no matter where they are in the world,

can have these problems addressed.

supere estes problemas.

So what if I told you

Que pasa se vos digo

that you didn't really need a million-dollar robot

que non se necesita un robot dun millón de dólares

to provide remote surgery?

para realizar cirurxía remota?

That all you needed was a phone, a tablet, or a computer,

Que todo o que necesitas é un teléfono, unha tableta ou un ordenador,

an internet connection,

conexión a Internet,

a confident colleague on the ground

un colega de confianza in situ

and one magic ingredient:

e o ingrediente máxico:

an augmented reality collaboration software.

un programa de colaboración en realidade aumentada.

Usando este programa

Using this augmented reality collaboration software,

an expert surgeon can now virtually transport himself

un cirurxián experto pode transportarse virtualmente

into any clinical setting

a calquera contorno clínico

simply by using his phone or tablet or computer,

só con usar o seu teléfono, tableta ou ordenador,

and he can visually and practically interact in an operation

e pode interactuar na operación visual e practicamente

from start to finish,

de principio a fin,

guiding and mentoring a local doctor through the procedure step by step.

guiando e controlando un médico local a través do procedemento paso a paso.

Well, enough of me telling you about it.

Ben, chega de charla.

I'd now like to show you.

Agora gustaríame ensinárvolo.

We're now going to go live to Dr. Marc Tompkins,

Ímonos unir en directo ao Dr. Marc Tompkins,

an orthopedic surgeon at the University of Minnesota.

cirurxián ortopédico da Universidade de Minnesota.

He's going to perform an arthroscopic surgery for us,

Vai realizar unha cirurxía artroscópica,

a keyhole surgery of the knee,

unha cirurxía laparoscópica do xeonllo,

and I'd like to disclose

e gustaríame aclarar

that this patient has consented to having their operation streamed.

que este paciente consentiu a retransmisión da súa operación.

I'd also like to point out that in the interest of time,

Tamén me gustaría comentar que por limitacións de tempo,

we're just going to go through the first steps,

soamente imos ver os primeiros pasos:

marking up the patient

marcar o paciente

and just identifying a few key anatomical landmarks.

e identificar algúns puntos anatómicos clave.

Hello, Dr. Tompkins, can you hear me?

Ola, Dr. Tompkins, pode oírme?

Dr. Mark Tompkins: Good morning, Nadine.

Dr. Mark Tompkins: Bos días, Nadine.

Nadine Hachach-Haram: Everyone from TED says hello.

Nadine Hachach-Haram: Saúdos de parte da audiencia de TED.

Audience: Hi.

Audiencia: Ola!

NHH: Alright, Dr. Tompkins, let's get started.

NHH: De acordo, Dr. Tompkins, imos empezar.

So let's start with our incisions and where we're going to make these,

Comecemos coas incisións; ímolas facer

on either side of the patellar tendon.

a ámbolos lados do tendón rotuliano.

So if you can make your incisions there and there,

Así que se pode facer as incisións aí, e aí,

that should hopefully get us into the knee.

deberiamos poder acceder ó xeonllo se todo vai ben.

MT: All right, I'm going in.

MT: De acordo, vou proceder.

NHH: Great.

NHH: Xenial.

So we're just getting inside the joint now.

Estamos entrando na articulación agora mesmo.

So why don't we go around and have a quick look at the meniscus.

Que tal se lle botamos unha ollada ao menisco dende o outro lado?

MT: Perfect.

MT: Perfecto.

NHH: Great, so we can see there's a small tear there on the meniscus,

NHH: Xenial, podemos ver que hai unha pequena rotura no menisco,

but otherwise it looks alright.

pero o demais parece que está ben.

And if you turn and head to this direction,

Se xira e se dirixe aquí,

follow my finger,

siga o meu dedo,

let's have a quick look at the ACL and the PCL.

imos mirar un momento o LCA e o LCP.

That's your ACL there, that looks quite healthy,

Ese é o LCA, que parece bastante san,

no problems there.

sen problemas por aí.

So we've just identified that small meniscus tear there,

É certo que encontramos esa pequena rotura no menisco,

but otherwise the fluid around the joint looks OK as well.

pero o líquido que cobre a articulación parece que tamén está ben.

All right, thank you very much, Dr. Tompkins. Thank you for your time.

De acordo, moitas grazas, Dr. Tompkins. Grazas polo seu tempo.

I'll let you continue.

Déixoo continuar.

Have a good day. Bye.

Teña un bo día. Adeus.

(Applause)

(Aplausos)

So I hope through this simple demonstration

Espero que mediante esta simple demostración

I was able to illustrate to you just how powerful this technology can be.

fora capaz de transmitirvos como de potente pode ser esta tecnoloxía.

And I'd like to point out that I wasn't using any special equipment,

E gustaríame aclarar que non estaba usando ningún equipamento especial,

só o meu portátil e unha cámara moi sinxela.

just my laptop and a really simple webcam.

We're so used to using digital technology

Estamos moi acostumados a usar a tecnoloxía dixital

to communicate through voice and text and video,

para comunicarnos mediante voz, texto e vídeo,

but augmented reality can do something so much deeper.

pero a realidade aumentada pode lograr algo máis profundo.

It allows two people to virtually interact

Permite que dúas persoas interactúen virtualmente

in a way that mimics how they would collaborate in person.

dun xeito que se parece a como o farían presencialmente.

Being able to show someone what you want to do,

Ser capaz de mostrarlle a alguén que queres facer,

to illustrate and demonstrate and gesture,

ilustrar, demostrar, xesticular,

is so much more powerful than just telling them.

é moito máis eficaz que só dicirllo.

And it can make for such a great learning tool,

E pode ser unha gran ferramenta didáctica,

because we learn better through direct experience.

porque aprendemos mellor con experiencias directas.

So how is this making a difference around the world?

Así que, como pode marcar a diferenza no mundo?

Well, back in my teaching hospital,

No hospital onde traballo,

we've been using this to support local district general hospitals

estámolo usando para apoiar hospitais xerais locais,

and providing skin cancer surgery and trauma treatment.

realizando cirurxías de cancro de pel e en traumatoloxía.

Now, patients can access care at a local level.

Agora, os pacientes poden acceder a coidados médicos a un nivel local.

This reduces their travel time, improves their access,

Isto reduce o tempo que gastan viaxando, mellora a súa accesibilidade

and saves money.

e afórralles cartos.

We've even started seeing its use in wound care management with nurses

Incluso empezamos a ver enfermeiros usalo para realizar curas

and in outpatient management.

e atender pacientes ambulatorios.

Most recently, and quite exciting,

Hai pouco, e bastante emocionante,

it was used in supporting a surgeon through a cancer removal of a kidney.

usouse para axudar a un cirurxián a extirpar un cancro dun ril.

And I'd like to just share with you a very quick video here.

Gustaríame ensinarvos un vídeo moi curto.

I apologize for some of the gruesome views.

Perdoádeme polas imaxes espantosas.

(Video) Doctor 1: OK. Show me again.

(Vídeo) Doutor 1: Vale. Ensínamo de novo.

Doctor 2: If you see here,

Doutor 2: Se te fixas aquí,

that's the upper part, the most outer part of your tumor.

é a parte superior, a parte máis externa do tumor.

Doctor 1: Yes.

Doutor 1: Si.

Doctor 2: So it's three centimeters deep,

Doutor 2: Ten tres centímetros de profundidade,

so this should be three centimeters.

así que debería medir tres centímetros.

Doctor 1: Yes, yes.

Doutor 1: Si, si.

Doctor 2: OK, so you need to get a 3.5 margin.

Doutor 2: Vale, entón necesitas unha marxe de 3,5 cm

Doctor 1: I'm going to show you anyway

Doutor 1: Voucho ensinar de todas formas

and tell me what you think about it.

e disme o que pensas.

NHH: We're also seeing the use of this technology at a global scale,

NHH: Tamén vemos o uso desta tecnoloxía a nivel mundial,

and one of the most heartwarming stories I can recall

e unha das historias máis conmovedoras que recordo

is from the town of Trujillo in the north of Lima in Peru,

pasou en Trujillo, un pobo ao norte de Lima, no Perú,

where this technology was used to support the provision

onde esta tecnoloxía se usou para axudar

of cleft lip and palate surgery to children,

a corrixir o labio leporino e o padal fendido de nenos,

children from poor backgrounds who didn't have access to health insurance.

nenos de contornas pobres que non tiñan seguro médico.

And in this town, there was a hospital with one surgeon

E nesta vila había un hospital cunha cirurxiá

working hard to provide this care,

traballando duro para dar este servizo,

Dr. Soraya.

a Dra. Soraya.

Now, Dr. Soraya was struggling under the sheer demand

Á Dra. Soraya estábaselle facendo costa arriba

of her local population,

atender a todos no seu pobo,

as well as the fact that she wasn't specifically trained in this procedure.

á parte de que non estaba especializada neste procedemento.

And so, with the help of a charity,

Así, coa axuda dunha ONG,

we were able to connect her with a cleft surgeon in California,

conseguimos que se conectara cun cirurxián de padal en California,

and using this technology, he was able to guide her and her colleagues

e usando esta tecnoloxía, foi capaz de guiala a ela e ós seus axudantes

through the procedure step by step,

paso a paso neste procedemento,

guiding them, training them and teaching them.

guiándoos, ensinándolles e dándolles consellos.

Within a few months,

En tan só uns meses,

they were able to perform 30 percent more operations

foron capaces de aumentar nun 30 por cento

with less and less complications.

o número de operacións, cada vez con menos complicacións.

And now Dr. Soraya and her team can perform these operations

E agora, a Dra. Soraya e o seu equipo poden realizar estas operacións

independently, competently and confidently.

sen axuda, de forma competente e segura.

And I remember one quote from a mother who said,

Acórdome dunha frase que me dixo unha nai:

"This technology gave my daughter her smile."

"Esta tecnoloxía deulle á miña filla o seu sorriso."

For me, this is the real power of this technology.

Para min, este é o verdadeiro poder desta tecnoloxía.

The beauty is that it breaks boundaries.

O bonito é que rompe barreiras.

It transcends all technological difficulties.

Transcende todas as dificultades da tecnoloxía.

It connects people. It democratizes access.

Conecta a xente. Fai que sexa accesible para todos.

Wi-Fi and mobile technology are growing rapidly,

O wifi e a tecnoloxía móbil crecen moi rápido,

and they should play a role in boosting surgical provision.

e deberían ter un papel clave no aumento do acceso á cirurxía.

We've even seen it used in conflict zones where there's considerable risk

Vimos o seu uso en zonas conflitivas, onde levar persoal cirúrxico

in getting specialist surgeons to certain locations.

a determinados lugares supón un risco considerable.

In a world where there are more mobile devices

Nun mundo onde hai máis dispositivos móbiles

than there are human beings,

que seres humanos,

it truly has a global reach.

esta ferramenta ten moito alcance.

Of course, we've still got a long way

Por suposto, aínda queda moito

before we can solve the problem of getting surgery to five billion people,

antes de dar acceso a cirurxía a cinco mil millóns de persoas,

and unfortunately,

e por desgraza,

some people still don't have access to internet.

aínda hai persoas que non teñen acceso a Internet.

But things are rapidly moving in the right direction.

Pero as cousas avanzan rapidamente na boa dirección.

The potential for change is there.

O potencial para o cambio está aí.

My team and I are growing our global footprint,

Co meu equipo estamos aumentando a pegada que deixamos no mundo,

and we're starting to see the potential of this technology.

e estamos empezando a ver o potencial desta tecnoloxía.

Through digital technology,

Coa tecnoloxía dixital,

through simple, everyday devices that we take for granted,

usando dispositivos do día a día que todos damos por supostos,

through devices of the future,

mediante os dispositivos do futuro,

we can really do miraculous things.

podemos chegar a facer verdadeiros milagres.

Thank you.

Grazas.

(Applause)

(Aplausos)