According to the theories of human social development, we're now living through the fourth great epoch of technological advancement, the Information Age. Connectivity through digital technology is a modern miracle. We can say it has broken down barriers of time and space which separate people, and it's created a condition for an age where information, ideas can be shared freely.
Prema teorijama o ljudskom društvenom razvoju, mi se upravo nalazimo u četvrtoj velikoj epohi tehnološkog napretka, Informacijskom dobu. Povezanost putem digitalne tehnologije moderno je čudo. Možemo reći da je uklonilo prepreke vremena i prostora koje razdvajaju ljude i stvorilo uvjet za doba, u kojem se informacije i ideje mogu slobodno dijeliti.
But are these great accomplishments in digital technology really the endgame in terms of what can be achieved? I don't think so, and today I'd like to share with you how I believe digital technology can take us to even greater heights. I'm a surgeon by profession, and as I stand here today talking to all of you, five billion people around the world lack access to safe surgical care. Five billion people. That's 70 percent of the world's population, who according to the WHO's Lancet Commission can't even access simple surgical procedures as and when they need them.
Međutim, jesu li ova postignuća u digitalnoj tehnologiji uistinu strop u smislu onoga što se može postići? Ne bih rekla, i danas bih htjela podijeliti s vama kako nas digitalna tehnologija može odvesti u još veće visine. Po profesiji sam kirurg, i u ovom trenutku, dok vam ja držim ovaj govor, pet milijardi osoba u svijetu nema pristup sigurnoj kirurškoj skrbi. Pet milijardi osoba. To je 70 % svjetskog stanovništva, koji prema studiji SZO-e u časopisu Lancet, nema pristup ni jednostavnim kirurškim postupcima gdje i kada ih treba.
Let's zoom in on Sierra Leone, a country of six million people, where a recent study showed that there are only 10 qualified surgeons. That's one surgeon for every 600,000 people. The numbers are staggering, and we don't even need to look that far. If we look around us here in the US, a recent study reported that we need an extra 100,000 surgeons by 2030 to just keep up with the demand for routine surgical procedures. At the rate that we're going, we won't be meeting those numbers.
Fokusirajmo se na Sijeru Leone. Zemlju od šest milijuna stanovnika, gdje, po nedavnoj studiji, postoji svega deset kvalificiranih kirurga. To znači 600.000 ljudi po kirurgu. Brojke su zabrinjavajuće, ali čak ni ne moramo gledati tako daleko. Ako pogledamo ovdje u SAD-u, nedavna studija nam kaže da ćemo trebati dodatnih 100.000 kirurga do 2030. Samo u svrhu zadovoljavanja zahtjeva za rutinskim kirurškim zahvatima. Brzinom kojom se trenutno krećemo, nećemo uspjeti postići te brojke.
As a surgeon, this is a global issue that bothers me. It bothers me a lot, because I've seen firsthand how lack of access to safe and affordable healthcare can blight the lives of ordinary people. If you're a patient that needs an operation and there isn't a surgeon available, you're left with some really difficult choices: to wait, to travel, or not to have an operation at all.
Kao kirurg, to je globalni problem koji me zabrinjava. Muči me to jako, jer sam iz prve ruke vidjela kako nedostatak pristupa sigurnom i pristupačnom zdravstvu može upropastiti živote običnih ljudi. Ako ste vi pacijent kojem je potrebna operacija, a nema dostupnog kirurga, ostaju vam stvarno teški izbori: čekati, putovati ili uopće se ne podvrgnuti operaciji.
So what's the answer? Well, part of you are carrying some of that solution with you today: a smartphone, a tablet, a computer. Because for me, digital communications technology has the power to do so much more than just to allow us to shop online, to connect through social media platforms and to stay up to date. It has the power to help us solve some of the key issues that we face, like lack of access to vital surgical services. And today I'd like to share with you an example of how I think we can make that possible.
Dakle, što učiniti? E pa, neki od vas imaju dio rješenja sa sobom danas: pametni telefon, tablet, računalo. Jer, za mene, tehnologija digitalnih komunikacija ima moć činiti puno više, nego da nam samo omogućava online kupovinu, povezanost putem društvenih medija i da ostanemo ukorak s novostima. Ima moć pomoći nam da riješimo neke od ključnih problema s kojima smo suočeni, poput nedostatka pristupačnosti ključnih kirurških usluga. Danas bih htjela podijeliti s vama primjer toga kako ćemo to moći učiniti mogućim.
The history of surgery is filled with breakthroughs in how science and technology was able to help the surgeons of the day face their greatest challenges. If we go back several hundred years, an understanding of microbiology led to the development of antiseptic techniques, which played a big role in making sure patients were able to stay alive postsurgery. Fast-forward a few hundred years and we developed keyhole or arthroscopic surgery, which combines video technology and precision instruments to make surgery less invasive. And more recently, a lot of you will be aware of robotic surgery, and what robotics brings to surgery is much like modern automated machinery, ultraprecision, the ability to carry out procedures at the tiniest scales with a degree of accuracy that even surpasses the human hand. But robotic surgery also introduced something else to surgery: the idea that a surgeon doesn't actually have to be standing at the patient's bedside to deliver care, that he could be looking at a screen and instructing a robot through a computer. We call this remote surgery.
Povijest kirurgije puna je proboja gdje su znanost i tehnologija mogle pomoći tadašnjim kirurzima da se suoče sa svojim najvećim izazovima. Ako se vratimo u prošlost par stotina godina, shvaćanje mikrobiologije dovelo je do razvoja antiseptičkih tehnika, koje su imale veliku ulogu u osiguravanju da pacijenti ostanu živi nakon operacije. Premotajmo par stotina godina i razvili smo artroskopsku kirurgiju, koja spaja video tehnologiju i precizne instrumente kako bi učinila kirurgiju manje invazivnom. Od nedavno, većina vas bit će upoznata s robotskom kirurgijom i da je ono što robotika pridonosi kirurgiji poput moderne automatizacije; vrlo visoka preciznost. Sposobnost obavljanja zahvata u sićušnim dimenzijama, ali sa stupnjem preciznosti koji nadilazi ljudsku ruku. Međutim, robotska kirurgija je također uvela još nešto u kirurgiju: ideju da kirurg ne mora fizički stajati nad pacijentovim krevetom da bi mu obavljao zahvat, nego da bi mogao promatrati kroz ekran i davati naredbe robotu putem računala. To nazivamo telekirurgijom.
It is incumbent on us to find solutions that solve these answers in a cost-effective and scalable way, so that everyone, no matter where they are in the world, can have these problems addressed.
Trenutni nam je zadatak naći rješenja za ove odgovore na cjenovno učinkovit i svjetski primjenjiv način, tako da svi, bez obzira na to gdje se nalazili na svijetu, mogu dobiti rješenja za svoje probleme.
So what if I told you that you didn't really need a million-dollar robot to provide remote surgery? That all you needed was a phone, a tablet, or a computer, an internet connection, a confident colleague on the ground and one magic ingredient: an augmented reality collaboration software. Using this augmented reality collaboration software, an expert surgeon can now virtually transport himself into any clinical setting simply by using his phone or tablet or computer, and he can visually and practically interact in an operation from start to finish, guiding and mentoring a local doctor through the procedure step by step.
Dakle, što kad bih vam rekla da vam zapravo nije potreban robot od milijun dolara da biste pružali telekirurgiju? Sve što bi vam trebalo je mobitel, tablet ili računalo, internetska veza, samouvjeren kolega na lokaciji i jedan magični sastojak: softver za suradnju putem proširene stvarnosti. Uporabom ovog softvera za suradnju putem proširene stvarnosti, stručni kirurg može se virtualno teleportirati na bilo kakvo kliničko okruženje, jednostavno koristeći svoj mobitel, tablet ili računalo i može vizualno i praktično sudjelovati u operaciji, od početka do kraja, vodeći i mentorirajući liječnika na lokaciji korak po korak kroz zahvat.
Well, enough of me telling you about it. I'd now like to show you. We're now going to go live to Dr. Marc Tompkins, an orthopedic surgeon at the University of Minnesota. He's going to perform an arthroscopic surgery for us, a keyhole surgery of the knee, and I'd like to disclose that this patient has consented to having their operation streamed. I'd also like to point out that in the interest of time, we're just going to go through the first steps, marking up the patient and just identifying a few key anatomical landmarks. Hello, Dr. Tompkins, can you hear me? Dr. Mark Tompkins: Good morning, Nadine.
Dobro, dosta o samom pričanju o tome. Htjela bih vam pokazati sad. Pridružujemo se uživo dr. Marcu Tompkinsu, ortopedskom kirurgu na Sveučilištu u Minnesoti. On će obaviti jednu artroskopsku operaciju za nas, operaciju koljena kroz mali rez. Htjela bih priopćiti da je pacijent dao pristanak za prijenos njegove operacije. Htjela bih također istaknuti da, s vremenom na umu, ćemo proći samo kroz prvih par koraka; obilježavanje pacijenta i identificiranje nekoliko ključnih anatomskih oznaka. Halo, dr. Tompkinse, čujete li me? 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. So let's start with our incisions and where we're going to make these, on either side of the patellar tendon. So if you can make your incisions there and there, that should hopefully get us into the knee.
NHH: Dobro, dr. Tompkins, možemo početi. Počnimo s rezovima i gdje ćemo ih napraviti, na obje strane patelarne tetive. Dakle, ako biste mogli učiniti svoje rezove ovdje i ovdje, to bi nas trebalo uvesti u koljeno.
MT: All right, I'm going in.
MT: U redu, ulazim.
NHH: Great. So we're just getting inside the joint now. So why don't we go around and have a quick look at the meniscus.
NHH: Odlično. Upravo ulazimo unutar zgloba. 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, but otherwise it looks alright. And if you turn and head to this direction, follow my finger, let's have a quick look at the ACL and the PCL. That's your ACL there, that looks quite healthy, no problems there. So we've just identified that small meniscus tear there, but otherwise the fluid around the joint looks OK as well. All right, thank you very much, Dr. Tompkins. Thank you for your time. I'll let you continue. Have a good day. Bye.
NHH: Odlično, sad možemo vidjeti da postoji manji rascjep na meniskusu, ali inače izgleda u redu. A ako se okrenete i pođete u ovom smjeru, pratite moj prst, bacimo pogled na prednji i stražnji križni ligament. To vam je stražnji, taj izgleda zdravo. Tu nema problema. Dakle, upravo smo prepoznali manji rascjep meniskusa ovdje, ali inače tekućina oko zgloba izgleda O.K. također. U redu, hvala vam lijepa, dr. Tompkins. Hvala na vašem vremenu. Dopustit ću vam da nastavite. Želim vam ugodan dan. 'Đenja.
(Applause)
(Pljesak)
So I hope through this simple demonstration I was able to illustrate to you just how powerful this technology can be. And I'd like to point out that I wasn't using any special equipment, just my laptop and a really simple webcam. We're so used to using digital technology to communicate through voice and text and video, but augmented reality can do something so much deeper. It allows two people to virtually interact in a way that mimics how they would collaborate in person. Being able to show someone what you want to do, to illustrate and demonstrate and gesture, is so much more powerful than just telling them. And it can make for such a great learning tool, because we learn better through direct experience.
Dakle, nadam se da sam kroz ovu jednostavnu demonstraciju uspjela prikazati vam koliko moćna ova tehnologija može biti. Htjela bih istaknuti da nisam koristila nikakvu posebnu opremu, samo svoj laptop i običnu web kameru. Toliko smo naviknuti na korištenje digitalne tehnologije za komunikaciju putem poziva, poruke i videa, ali proširena stvarnost može učiniti nešto puno značajnije. Ono dopušta dvjema osobama da virtualno komuniciraju na način koji imitira kako bi one surađivale uživo. Biti u mogućnosti pokazati što želiš učiniti, prikazati, pokazati i gestikulirati, puno je moćnije nego samo im govoriti. I može poslužiti kao sjajan alat za učenje, jer učimo bolje kroz izravno iskustvo.
So how is this making a difference around the world? Well, back in my teaching hospital, we've been using this to support local district general hospitals and providing skin cancer surgery and trauma treatment. Now, patients can access care at a local level. This reduces their travel time, improves their access, and saves money. We've even started seeing its use in wound care management with nurses and in outpatient management. Most recently, and quite exciting, it was used in supporting a surgeon through a cancer removal of a kidney. And I'd like to just share with you a very quick video here. I apologize for some of the gruesome views.
Dakle, kako ovo čini razliku u svijetu? U mojoj sveučilišnoj bolnici, koristimo ovu tehnologiju za podržavanje okružnih općih bolnica te pružanje operacije raka kože i liječenje trauma. Pacijenti sada imaju pristup njezi na lokalnoj razini. Ona smanjuje vrijeme potrebno za prijevoz, poboljšava pristupačnost i štedi novac. Počeli smo uviđati njezinu korisnost i u tretiranju rana s medicinskim sestrama i u ambulantnom liječenju. Nedavno, i dosta uzbudljivo, koristila se kao potpora kirurgu za operaciju odstranjivanja raka bubrega. Htjela bih sada podijeliti jedan kratak video s vama. 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, that's the upper part, the most outer part of your tumor.
Doktor 2: Ako pogledaš ovdje, to je gornji dio, vanjski dio tumora.
Doctor 1: Yes.
Doktor 1: Da.
Doctor 2: So it's three centimeters deep, so this should be three centimeters.
Doktor 2: Dakle, dubok je tri cm, 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 and tell me what you think about it.
Doktor 1: Svejedno ću ti pokazati, a ti mi reci što misliš o tome.
NHH: We're also seeing the use of this technology at a global scale, and one of the most heartwarming stories I can recall is from the town of Trujillo in the north of Lima in Peru, where this technology was used to support the provision of cleft lip and palate surgery to children, children from poor backgrounds who didn't have access to health insurance. And in this town, there was a hospital with one surgeon working hard to provide this care, Dr. Soraya. Now, Dr. Soraya was struggling under the sheer demand of her local population, as well as the fact that she wasn't specifically trained in this procedure. And so, with the help of a charity, we were able to connect her with a cleft surgeon in California, and using this technology, he was able to guide her and her colleagues through the procedure step by step, guiding them, training them and teaching them. Within a few months, they were able to perform 30 percent more operations with less and less complications. And now Dr. Soraya and her team can perform these operations independently, competently and confidently. And I remember one quote from a mother who said, "This technology gave my daughter her smile."
NHH: Također uviđamo korisnost ove tehnologije i na svjetskoj razini. Jedna od najohrabrujućih priča koje se mogu sjetiti dolazi iz grada Trujillo u sjevernoj Limi u Peruu, gdje se ova tehnologija koristila kao potpora za pružanje operacije rascjepa usna i nepca za djecu, koja potječu iz siromašnih obitelji i nemaju pristup zdravstvenom osiguranju. U tom gradu, postoji bolnica s jednom kirurgicom koja marljivo radi kako bi pružala njegu, dr. Soraya. Dr. Soraya se mučila držati korak s količinom potražnje u njezinom lokalnom stanovništvu i također s činjenicom da nije imala specijalističku obuku za taj zahvat. I tako, uz pomoć dobrotvorne udruge, mogli smo ju spojiti sa specijalistom za rascjep usne iz Kalifornije i koristeći ovu tehnologiju, mogao je voditi nju i njezine kolege kroz operaciju korak po korak. Voditi ih, obučavati i podučiti. U nekoliko mjeseci, bili su sposobni obavljati 30 % više operacija sa sve manje komplikacija. Sada su dr. Soraya i njezin tim sposobni obavljati ove operacije samostalno, stručno i samopouzdano. Sjećam se izjave jedne majke koja je rekla: "Ova tehnologija je dala mojoj kćerki njezin osmijeh".
For me, this is the real power of this technology. The beauty is that it breaks boundaries. It transcends all technological difficulties. It connects people. It democratizes access. Wi-Fi and mobile technology are growing rapidly, and they should play a role in boosting surgical provision. We've even seen it used in conflict zones where there's considerable risk in getting specialist surgeons to certain locations. In a world where there are more mobile devices than there are human beings, it truly has a global reach. Of course, we've still got a long way before we can solve the problem of getting surgery to five billion people, and unfortunately, some people still don't have access to internet. But things are rapidly moving in the right direction. The potential for change is there. My team and I are growing our global footprint, and we're starting to see the potential of this technology.
Za mene, to je prava moć ove tehnologije. Njezina je ljepota što razbija barijere. Prelazi sve tehnološke poteškoće. Povezuje ljude. Demokatizira pristupačnost. Wi-Fi i mobilna tehnologija ubrzano rastu, stoga bi trebali igrati ulogu u poboljšavanju pružanja kirurgije. Vidjeli smo da se tehnologija koristi i u područjima sukoba, gdje postoji rizik u dovođenju kirurga specijalista do određenih lokacija. U svijetu u kojem postoji više mobilnih uređaja nego ljudi, ono uistinu ima svjetski doseg. Naravno, još uvijek nismo dovoljno uznapredovali da bismo riješili problem nedostupnosti kirurgije za pet milijardi osoba i, nažalost, neke osobe još uvijek nemaju pristup internetu. Ali stvari se ubrzano kreću u pravom smjeru. Potencijal za promjenu postoji. Moj tim i ja povećavamo svoj otisak na svjetskoj razini, te tek počinjemo uviđati mogućnosti ove tehnologije.
Through digital technology, through simple, everyday devices that we take for granted, through devices of the future, we can really do miraculous things.
Kroz digitalnu tehnologiju, kroz jednostavne, svakodnevne uređaje koje uzimamo zdravo za gotovo, kroz uređaje budućnosti, možemo učiniti uistinu čudesne stvari.
Thank you.
Hvala vam.
(Applause)
(Pljesak)