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

Prevoditelj: Ivana Varga Recezent: Tilen Pigac - EFZG

According to the theories of human social development,

Prema teorijama o ljudskom društvenom razvoju,

we're now living through the fourth great epoch

mi se upravo nalazimo u četvrtoj velikoj epohi

of technological advancement,

tehnološkog napretka,

the Information Age.

Informacijskom dobu.

Connectivity through digital technology is a modern miracle.

Povezanost putem digitalne tehnologije moderno je čudo.

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

Možemo reći da je uklonilo prepreke vremena i prostora koje razdvajaju ljude

and it's created a condition for an age

i stvorilo uvjet za doba,

where information, ideas can be shared freely.

u kojem se informacije i ideje mogu slobodno dijeliti.

But are these great accomplishments in digital technology

Međutim, jesu li ova postignuća u digitalnoj tehnologiji

really the endgame in terms of what can be achieved?

uistinu strop u smislu onoga što se može postići?

I don't think so,

Ne bih rekla,

and today I'd like to share with you

i danas bih htjela podijeliti s vama

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

kako nas digitalna tehnologija može odvesti u još veće visine.

I'm a surgeon by profession,

Po profesiji sam kirurg,

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

i u ovom trenutku, dok vam ja držim ovaj govor,

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

pet milijardi osoba u svijetu nema pristup sigurnoj kirurškoj skrbi.

Five billion people.

Pet milijardi osoba.

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

To je 70 % svjetskog stanovništva,

who according to the WHO's Lancet Commission

koji prema studiji SZO-e u časopisu Lancet,

can't even access simple surgical procedures

nema pristup ni jednostavnim kirurškim postupcima

as and when they need them.

gdje i kada ih treba.

Let's zoom in on Sierra Leone,

Fokusirajmo se na Sijeru Leone.

a country of six million people,

Zemlju od šest milijuna stanovnika,

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

gdje, po nedavnoj studiji, postoji svega deset kvalificiranih kirurga.

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

To znači 600.000 ljudi po kirurgu.

The numbers are staggering,

Brojke su zabrinjavajuće,

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

ali čak ni ne moramo gledati tako daleko.

If we look around us here in the US,

Ako pogledamo ovdje u SAD-u,

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

nedavna studija nam kaže da ćemo trebati dodatnih 100.000 kirurga do 2030.

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

Samo u svrhu zadovoljavanja zahtjeva za rutinskim kirurškim zahvatima.

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

Brzinom kojom se trenutno krećemo, nećemo uspjeti postići te brojke.

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

Kao kirurg, to je globalni problem koji me zabrinjava.

It bothers me a lot,

Muči me to jako,

because I've seen firsthand

jer sam iz prve ruke vidjela

how lack of access to safe and affordable healthcare

kako nedostatak pristupa sigurnom i pristupačnom zdravstvu

can blight the lives of ordinary people.

može upropastiti živote običnih ljudi.

If you're a patient that needs an operation

Ako ste vi pacijent kojem je potrebna operacija,

and there isn't a surgeon available,

a nema dostupnog kirurga,

you're left with some really difficult choices:

ostaju vam stvarno teški izbori:

to wait, to travel,

čekati, putovati

or not to have an operation at all.

ili uopće se ne podvrgnuti operaciji.

So what's the answer?

Dakle, što učiniti?

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

E pa, neki od vas imaju dio rješenja sa sobom danas:

a smartphone, a tablet, a computer.

pametni telefon, tablet, računalo.

Because for me,

Jer, za mene,

digital communications technology has the power to do so much more

tehnologija digitalnih komunikacija ima moć činiti puno više,

than just to allow us to shop online,

nego da nam samo omogućava online kupovinu,

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

povezanost putem društvenih medija i da ostanemo ukorak s novostima.

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

Ima moć pomoći nam da riješimo neke od ključnih problema s kojima smo suočeni,

like lack of access to vital surgical services.

poput nedostatka pristupačnosti ključnih kirurških usluga.

And today I'd like to share with you

Danas bih htjela podijeliti s vama

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

primjer toga kako ćemo to moći učiniti mogućim.

The history of surgery is filled with breakthroughs

Povijest kirurgije puna je proboja

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

gdje su znanost i tehnologija mogle pomoći tadašnjim kirurzima

da se suoče sa svojim najvećim izazovima.

face their greatest challenges.

If we go back several hundred years,

Ako se vratimo u prošlost par stotina godina,

an understanding of microbiology

shvaćanje mikrobiologije

led to the development of antiseptic techniques,

dovelo je do razvoja antiseptičkih tehnika,

which played a big role in making sure

koje su imale veliku ulogu u osiguravanju

patients were able to stay alive postsurgery.

da pacijenti ostanu živi nakon operacije.

Fast-forward a few hundred years

Premotajmo par stotina godina

and we developed keyhole or arthroscopic surgery,

i razvili smo artroskopsku kirurgiju,

which combines video technology and precision instruments

koja spaja video tehnologiju i precizne instrumente

to make surgery less invasive.

kako bi učinila kirurgiju manje invazivnom.

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

Od nedavno, većina vas bit će upoznata s robotskom kirurgijom

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

i da je ono što robotika pridonosi kirurgiji poput moderne automatizacije;

ultraprecision,

vrlo visoka preciznost.

the ability to carry out procedures at the tiniest scales

Sposobnost obavljanja zahvata u sićušnim dimenzijama,

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

ali sa stupnjem preciznosti koji nadilazi ljudsku ruku.

But robotic surgery also introduced something else to surgery:

Međutim, robotska kirurgija je također uvela još nešto u kirurgiju:

the idea that a surgeon

ideju da kirurg

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

ne mora fizički stajati nad pacijentovim krevetom da bi mu obavljao zahvat,

that he could be looking at a screen

nego da bi mogao promatrati kroz ekran

and instructing a robot through a computer.

i davati naredbe robotu putem računala.

We call this remote surgery.

To nazivamo telekirurgijom.

It is incumbent on us

Trenutni nam je zadatak

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

naći rješenja za ove odgovore na cjenovno učinkovit i svjetski primjenjiv način,

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

tako da svi, bez obzira na to gdje se nalazili na svijetu,

can have these problems addressed.

mogu dobiti rješenja za svoje probleme.

So what if I told you

Dakle, što kad bih vam rekla

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

da vam zapravo nije potreban robot od milijun dolara

to provide remote surgery?

da biste pružali telekirurgiju?

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

Sve što bi vam trebalo je mobitel, tablet ili računalo,

an internet connection,

internetska veza,

a confident colleague on the ground

samouvjeren kolega na lokaciji

and one magic ingredient:

i jedan magični sastojak:

an augmented reality collaboration software.

softver za suradnju putem proširene stvarnosti.

Uporabom ovog softvera za suradnju putem proširene stvarnosti,

Using this augmented reality collaboration software,

an expert surgeon can now virtually transport himself

stručni kirurg može se virtualno teleportirati

into any clinical setting

na bilo kakvo kliničko okruženje,

simply by using his phone or tablet or computer,

jednostavno koristeći svoj mobitel, tablet ili računalo

and he can visually and practically interact in an operation

i može vizualno i praktično sudjelovati u operaciji,

from start to finish,

od početka do kraja,

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

vodeći i mentorirajući liječnika na lokaciji korak po korak kroz zahvat.

Well, enough of me telling you about it.

Dobro, dosta o samom pričanju o tome.

I'd now like to show you.

Htjela bih vam pokazati sad.

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

Pridružujemo se uživo dr. Marcu Tompkinsu,

an orthopedic surgeon at the University of Minnesota.

ortopedskom kirurgu na Sveučilištu u Minnesoti.

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

On će obaviti jednu artroskopsku operaciju za nas,

a keyhole surgery of the knee,

operaciju koljena kroz mali rez.

and I'd like to disclose

Htjela bih priopćiti

that this patient has consented to having their operation streamed.

da je pacijent dao pristanak za prijenos njegove operacije.

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

Htjela bih također istaknuti da, s vremenom na umu,

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

ćemo proći samo kroz prvih par koraka;

marking up the patient

obilježavanje pacijenta

and just identifying a few key anatomical landmarks.

i identificiranje nekoliko ključnih anatomskih oznaka.

Hello, Dr. Tompkins, can you hear me?

Halo, dr. Tompkinse, čujete li me?

Dr. Mark Tompkins: Good morning, Nadine.

Dr. Tompkins: Dobro jutro, Nadine.

Nadine Hachach-Haram: Everyone from TED says hello.

Nadine Hachach-Haram: Svi iz TED-a kažu bok.

Audience: Hi.

Publika: Bok.

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

NHH: Dobro, dr. Tompkins, možemo početi.

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

Počnimo s rezovima i gdje ćemo ih napraviti,

on either side of the patellar tendon.

na obje strane patelarne tetive.

So if you can make your incisions there and there,

Dakle, ako biste mogli učiniti svoje rezove ovdje i ovdje,

that should hopefully get us into the knee.

to bi nas trebalo uvesti u koljeno.

MT: All right, I'm going in.

MT: U redu, ulazim.

NHH: Great.

NHH: Odlično.

So we're just getting inside the joint now.

Upravo ulazimo unutar zgloba.

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

Zašto ne bismo pošli i bacili pogled na meniskus.

MT: Perfect.

MT: Savršeno.

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

NHH: Odlično, sad možemo vidjeti da postoji manji rascjep na meniskusu,

but otherwise it looks alright.

ali inače izgleda u redu.

And if you turn and head to this direction,

A ako se okrenete i pođete u ovom smjeru,

follow my finger,

pratite moj prst,

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

bacimo pogled na prednji i stražnji križni ligament.

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

To vam je stražnji, taj izgleda zdravo.

no problems there.

Tu nema problema.

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

Dakle, upravo smo prepoznali manji rascjep meniskusa ovdje,

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

ali inače tekućina oko zgloba izgleda O.K. također.

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

U redu, hvala vam lijepa, dr. Tompkins. Hvala na vašem vremenu.

I'll let you continue.

Dopustit ću vam da nastavite.

Have a good day. Bye.

Želim vam ugodan dan. 'Đenja.

(Applause)

(Pljesak)

So I hope through this simple demonstration

Dakle, nadam se da sam kroz ovu jednostavnu demonstraciju

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

uspjela prikazati vam koliko moćna ova tehnologija može biti.

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

Htjela bih istaknuti da nisam koristila nikakvu posebnu opremu,

just my laptop and a really simple webcam.

samo svoj laptop i običnu web kameru.

We're so used to using digital technology

Toliko smo naviknuti na korištenje digitalne tehnologije

to communicate through voice and text and video,

za komunikaciju putem poziva, poruke i videa,

but augmented reality can do something so much deeper.

ali proširena stvarnost može učiniti nešto puno značajnije.

Ono dopušta dvjema osobama da virtualno komuniciraju

It allows two people to virtually interact

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

na način koji imitira kako bi one surađivale uživo.

Being able to show someone what you want to do,

Biti u mogućnosti pokazati što želiš učiniti,

to illustrate and demonstrate and gesture,

prikazati, pokazati i gestikulirati,

is so much more powerful than just telling them.

puno je moćnije nego samo im govoriti.

And it can make for such a great learning tool,

I može poslužiti kao sjajan alat za učenje,

because we learn better through direct experience.

jer učimo bolje kroz izravno iskustvo.

So how is this making a difference around the world?

Dakle, kako ovo čini razliku u svijetu?

Well, back in my teaching hospital,

U mojoj sveučilišnoj bolnici,

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

koristimo ovu tehnologiju za podržavanje okružnih općih bolnica

and providing skin cancer surgery and trauma treatment.

te pružanje operacije raka kože i liječenje trauma.

Now, patients can access care at a local level.

Pacijenti sada imaju pristup njezi na lokalnoj razini.

This reduces their travel time, improves their access,

Ona smanjuje vrijeme potrebno za prijevoz, poboljšava pristupačnost

and saves money.

i štedi novac.

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

Počeli smo uviđati njezinu korisnost i u tretiranju rana s medicinskim sestrama

and in outpatient management.

i u ambulantnom liječenju.

Most recently, and quite exciting,

Nedavno, i dosta uzbudljivo,

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

koristila se kao potpora kirurgu za operaciju odstranjivanja raka bubrega.

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

Htjela bih sada podijeliti jedan kratak video s vama.

I apologize for some of the gruesome views.

Ispričavam se zbog možda jezivih slika.

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

(Video) Doktor 1: U redu. Pokaži mi još jednom.

Doctor 2: If you see here,

Doktor 2: Ako pogledaš ovdje,

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

to je gornji dio, vanjski dio tumora.

Doctor 1: Yes.

Doktor 1: Da.

Doctor 2: So it's three centimeters deep,

Doktor 2: Dakle, dubok je tri cm,

so this should be three centimeters.

tako da bi ovo trebalo biti tri cm.

Doctor 1: Yes, yes.

Doktor 1: Da, da.

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

Doktor 2: O.K., dakle, treba biti margina od 3,5 cm.

Doctor 1: I'm going to show you anyway

Doktor 1: Svejedno ću ti pokazati,

and tell me what you think about it.

a ti mi reci što misliš o tome.

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

NHH: Također uviđamo korisnost ove tehnologije i na svjetskoj razini.

and one of the most heartwarming stories I can recall

Jedna od najohrabrujućih priča koje se mogu sjetiti

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

dolazi iz grada Trujillo u sjevernoj Limi u Peruu,

where this technology was used to support the provision

gdje se ova tehnologija koristila kao potpora za pružanje

of cleft lip and palate surgery to children,

operacije rascjepa usna i nepca za djecu,

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

koja potječu iz siromašnih obitelji i nemaju pristup zdravstvenom osiguranju.

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

U tom gradu, postoji bolnica s jednom kirurgicom

working hard to provide this care,

koja marljivo radi kako bi pružala njegu,

Dr. Soraya.

dr. Soraya.

Now, Dr. Soraya was struggling under the sheer demand

Dr. Soraya se mučila držati korak s količinom potražnje

of her local population,

u njezinom lokalnom stanovništvu

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

i također s činjenicom da nije imala specijalističku obuku za taj zahvat.

And so, with the help of a charity,

I tako, uz pomoć dobrotvorne udruge,

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

mogli smo ju spojiti sa specijalistom za rascjep usne iz Kalifornije

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

i koristeći ovu tehnologiju, mogao je voditi nju i njezine kolege

through the procedure step by step,

kroz operaciju korak po korak.

guiding them, training them and teaching them.

Voditi ih, obučavati i podučiti.

Within a few months,

U nekoliko mjeseci,

they were able to perform 30 percent more operations

bili su sposobni obavljati 30 % više operacija

with less and less complications.

sa sve manje komplikacija.

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

Sada su dr. Soraya i njezin tim sposobni obavljati ove operacije

independently, competently and confidently.

samostalno, stručno i samopouzdano.

And I remember one quote from a mother who said,

Sjećam se izjave jedne majke koja je rekla:

"This technology gave my daughter her smile."

"Ova tehnologija je dala mojoj kćerki njezin osmijeh".

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

Za mene, to je prava moć ove tehnologije.

The beauty is that it breaks boundaries.

Njezina je ljepota što razbija barijere.

It transcends all technological difficulties.

Prelazi sve tehnološke poteškoće.

It connects people. It democratizes access.

Povezuje ljude. Demokatizira pristupačnost.

Wi-Fi and mobile technology are growing rapidly,

Wi-Fi i mobilna tehnologija ubrzano rastu,

and they should play a role in boosting surgical provision.

stoga bi trebali igrati ulogu u poboljšavanju pružanja kirurgije.

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

Vidjeli smo da se tehnologija koristi i u područjima sukoba, gdje postoji rizik

in getting specialist surgeons to certain locations.

u dovođenju kirurga specijalista do određenih lokacija.

In a world where there are more mobile devices

U svijetu u kojem postoji više mobilnih uređaja

than there are human beings,

nego ljudi,

it truly has a global reach.

ono uistinu ima svjetski doseg.

Of course, we've still got a long way

Naravno, još uvijek nismo dovoljno uznapredovali

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

da bismo riješili problem nedostupnosti kirurgije za pet milijardi osoba

and unfortunately,

i, nažalost,

some people still don't have access to internet.

neke osobe još uvijek nemaju pristup internetu.

But things are rapidly moving in the right direction.

Ali stvari se ubrzano kreću u pravom smjeru.

The potential for change is there.

Potencijal za promjenu postoji.

My team and I are growing our global footprint,

Moj tim i ja povećavamo svoj otisak na svjetskoj razini,

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

te tek počinjemo uviđati mogućnosti ove tehnologije.

Through digital technology,

Kroz digitalnu tehnologiju,

through simple, everyday devices that we take for granted,

kroz jednostavne, svakodnevne uređaje koje uzimamo zdravo za gotovo,

through devices of the future,

kroz uređaje budućnosti,

we can really do miraculous things.

možemo učiniti uistinu čudesne stvari.

Thank you.

Hvala vam.

(Applause)

(Pljesak)