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.
根据人类社会发展的理论, 我们目前正在经历着科技进展的 第四时期, 信息时代 由数字科技所提供的连接性是一个现代奇迹 这种连接打破了人们之间的时间与空间屏障, 并且创造了一个 可以自由分享信息和想法的时代
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.
但是数字科技带来的伟大成就 真的就仅此而已了吗? 我并不这么认为, 今天我想跟大家分享一下 我对数字科技未来新高度的展望 我是一名外科医生, 在我站在这里跟你们讲话的同时, 全球各地有五十亿的人缺少安全的手术护理 五十亿人 占了有全球70%的人口, 根据世界卫生组织“柳叶刀委员会”的标准, 他们甚至连最基本的外科手术 都进行不了
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.
让我们看看塞拉利昂, 这是一个六百万人口的国家, 一项近期的研究指出那里只有十名合格的外科医生 那就是六十万人民指望着一名医生 数字很惊人, 我们甚至不用看得那么远 如果我们关注一下美国, 一项研究报告说在2030年前 我们需要额外的十万名外科医生 仅仅来应对日常的外科手术需求 而依照我们现在的发展速度 这十万是达不到的
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.
作为一名外科医生 这个全球性的问题很是困扰着我 使我心烦意躁, 因为我亲身经历过, 如果接收不到安全的承担得起的护理 老百姓的生活将会深深的受到伤害 如果你是一名急需进行手术的患者 可是当时并没有空闲的外科医生, 你只有这几项艰难选择: 等待,另寻他路, 或者放弃治疗
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.
所以,怎么解决呢? 其实,今日在座的各位就携带着一部分: 一部智能手机,一个平板电脑或者一台电脑 因为对我而言, 数字通信技术拥有更强大的威力 不仅仅能让我们网络购物, 与朋友们在社交媒体中聊天,跟上潮流 它还可以解决我们面临的一些关键问题, 比如难以接受到关键手术 今天我想跟大家分享一下 我对如何实现这个问题的想法
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.
手术的历史充满着科学和技术上的突破, 这些突破帮助如今的外科医生, 面临严峻的挑战 我们如果回到几百年前, 当时微生物学的发现 带来了杀菌技术的发展, 这项技术大大提高了 病人术后的存活率 往后快进个几百年, 我们发明了“微创”手术 也就是关节镜手术, 这种技术结合了视频技术和高精密仪器 减少了手术产生的创伤 就在不远的将来 机器人手术将来到我们身边, 而这种技术就像现代的机械技术一样, 超级精密, 它可以在最细小的程度上进行手术 如此程度甚至超过了人手的精度 机器人手术还给手术带来一种新的想法: 一名外科医生, 并不需要亲身站在患者面前进行手术 他可以看着屏幕 使用电脑操控着机器人, 我们称之为“远距外科”
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.
我们有义务, 用合算的,可发展的方式解决这些问题, 实现无论何时何地, 大家都可以得到帮助
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.
如果我告诉你们 其实并不需要一个百万美元的机器人 来进行远距手术 你需要的全部 只是一部手机,一个平板电脑或者一台电脑, 连接上互联网, 还有一名有信心的外科医生在线, 再加上一点点魔法: 一个增强现实协同软件 使用这部软件, 一名专业的外科医生可以虚拟的“传输”他自己 到任何一家诊所 仅仅通过他的手机,平板或者电脑, 虚拟的进行一场手术 从头至尾, 引导着现场医生一步步地进行手术
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.
好啦,我说的已经够多的了 我想给你们展示一下 我将直播一场由Marc Tompkins大夫, 一名明尼苏达大学的矫形外科医师, 主刀的关节镜手术, 也就是对于膝盖骨的微创手术 我想声明一下, 这名患者已经准许我们直播这场手术了 另外由于时间关系, 我们只会观看最开始的部分, 也就是诊断一下患者, 识别出几处关键的解剖标志 您好,Tompkins大夫,您听得见我吗? 早安,Nadine
Nadine Hachach-Haram: Everyone from TED says hello.
TED现场的观众请欢迎一下他
Audience: Hi.
Hi~
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.
好的Tompkins大夫,让我们开始吧 我们先从这些切口开始, 它们的位置在膝盖肌腱的两侧, 如果你能在那里和那里开口, 就能很顺利地到达膝盖
MT: All right, I'm going in.
好的,我要开始了
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.
好的 我们开始进入这些关节里面去了 让我们来快速检查一下“半月板”,
MT: Perfect.
没问题
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.
好的,我们可以看到半月板有一点小小的撕裂, 其他地方看上去没有问题 如果你朝着这个方向, 顺着我的手指, 让我们快速检查一下交叉韧带 看到韧带了,挺健康的, 没有问题 所以我们发现只是“半月板”有一点点撕裂, 其他地方,以及关节旁边的液体都看上去没有问题 好的,Tompkins大夫 十分感谢您的时间 我就不打扰您了,请继续 好运,拜拜
(Applause)
(掌声)
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.
我希望通过这一场小小的演示 可以给你们展现一下这项技术的强大之处 而且我还想指出我并没有使用任何特殊的设备, 只有我的笔记本电脑和一个普通的摄像头 我们都非常习惯使用数字科技 来进行语音,文字,视频沟通, 而增强现实可以做到更多更深 它可以让两个人进行虚拟互动, 就像他们是在方面合作一样 能够向一个人 通过说明、演示和手势来传达你的想法, 比仅仅通过语音强大很多 而且这项技术还可以制造很棒的学习工具, 因为我们在亲身经历中可以更好的学习
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.
所以,它如何改变全世界呢? 在我的教学医院中, 我们已经开始运用这项技术对一些本地的医院 提供皮肤癌手术和创伤治疗的帮助 现在病人只要在当地就可以接受治疗, 这减少了他们的交通时间,增加了更多渠道, 还很省钱 它甚至还可以帮助护士治疗病人伤口, 以及对于门诊病人的管理 就在最近,非常令人兴奋, 这项技术被用来帮助 一名外科医生移除一块癌变的肾脏, 我想给你们展示一下这个简短的视频 抱歉,它可能包含一些可怕的图像
(Video) Doctor 1: OK. Show me again.
(视频)医生1: 好了,让我再看一下
Doctor 2: If you see here, that's the upper part, the most outer part of your tumor.
医生2: 你看这里 这是上部,肿瘤的最外侧
Doctor 1: Yes.
医生1: 嗯
Doctor 2: So it's three centimeters deep, so this should be three centimeters.
医生2: 它有3厘米深, 所以这个要调到3厘米
Doctor 1: Yes, yes.
医生1: 好的
Doctor 2: OK, so you need to get a 3.5 margin.
医生2: 所以你得切除3.5厘米才可以
Doctor 1: I'm going to show you anyway and tell me what you think about it.
医生1: 反正我都要给你看, 跟我说一下你怎么看
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."
我们在全球都可以看到这项技术的运用, 而我可以回想起其中最暖心的故事 是源于秘鲁共和国,利马北部, 特鲁希略市中的一个小镇发生的, 这项技术被用作支持 一项对儿童施展的唇裂和腭裂手术, 这是一个来自贫穷家庭 没有健康保险的孩子 而这个小镇里的医院只有一名外科医生 努力地提供治疗, Soraya大夫 而Soraya大无法应对那么多 来自本地人民的需求, 并且她实际上并没有被专门培训过 如何进行这种手术 然后,通过基金会的帮助, 我们能够让她与一名加利福尼亚州的 唇腭裂外科医生取得联系, 通过这项技术 这名医生指导她和她的同事们 一步步地进行手术, 指引,培训并教导他们 几个月以来, 他们进行的手术多了30%, 而且并发症也越来越少了 现在,Soraya大夫与她的团队 能够自信并独立地完成这些手术 我还记得一位母亲曾说过的话: “这项技术给我的女儿带来了微笑”
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.
对于我来说 这项技术的威力就是如此 美妙的事,它打破了人们之间的间隔 它可以跨越一切技术困难 它联系着人们 它使访问民主化 无线和移动技术的发展十分迅速, 而他们应该对手术准确性的提升献出一份力 这项技术甚至还在一些冲突地区使用, 专业的外科医生去这些地区时会面临很大的危险 在这样一个 移动设备比人类还多的世界中, 它真的可以触及全球 当然,我们还要走一段很长的路 在我们能够解决五百万人民的手术问题之前, 令人不幸的是, 有些人仍然没有互联网连接 但是,世界正在向正确的方向快速发展 发展的潜力很大 我和我的团队正在全球化发展, 而我们才刚刚开始认识到这项技术的潜能
Through digital technology, through simple, everyday devices that we take for granted, through devices of the future, we can really do miraculous things.
通过数字技术, 通过我们生活中的普通设备, 通过未来的设备, 我们真的可以创造奇迹
Thank you.
谢谢大家
(Applause)
(掌声)