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.
根據人類社會發展的理論, 我們現在正處在技術進展的 第四個重要時期: 「資訊時代」。 透過數位技術造成的連結性, 是現代的奇蹟。 我們可以說,原本會讓人分離的 時間空間阻礙,都被它打破了, 它所創造的時代中, 資訊、想法都能自由分享。
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.
但這些數位技術的偉大成就已近尾聲, 不能再達成更多了嗎? 我不認為如此, 而今天我想要和各位分享 我為何相信數位技術 可以帶我們再上一層樓。 我的職業是外科醫生, 今天我站在這裡和各位說話的同時, 全世界有五十億人無法 取得安全的手術護理。 五十億人。 那是世界人口的 70%, 世界衛生組織的柳葉刀委員會指出, 他們甚至在需要簡單外科手術時, 都求助無門。
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.
讓我們來看看獅子山共和國, 這個國家有六百萬人口, 一項近期研究指出, 只有十個合格的外科醫生。 也就是說每六十萬人 才有一個外科醫生。 這些數字很嚇人, 而我們甚至不用看那麼遙遠。 如果我們看看我們所在的美國, 一項近期研究指出,到 2030 年 我們還需要再增加十萬名外科醫生, 這樣才能剛好追上 例行外科手術的需求。 以目前的比率來看, 我們無法達成那個數字。
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.
身為外科醫生, 這個全球議題讓我困擾。 它讓我很困擾, 因為我曾經第一手見過, 無法取得安全且能負擔的健康照護 會如何摧殘一般人的生命。 如果你是需要動手術的病人, 卻沒有外科醫生有空, 你就得要做出非常困難的抉擇: 等候、到其他地方, 或完全不要動手術。
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.
所以答案是什麼? 在座有些人今天已把 一部份的解決方案帶在身上了: 智慧手機、平板電腦、電腦。 因為,對我來說, 數位通訊技術能夠做到的 遠遠超過線上購物、 透過社交媒體平台連結, 及取得最新資訊。 它有能力協助我們解決一些 我們面臨的關鍵議題, 比如無法取得攸關生死的手術服務。 今天我想要和各位分享個例子, 來說明我們要如何實現那個想法。
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.
手術的歷史充滿了突破, 在於科學與技術協助當時的外科醫生 面對最大挑戰的方式上不斷突破。 如果回到數百年前, 對於微生物學的了解 造成了防腐抗菌技術的發展, 對於確保病人在手術後還能 生存下來,這項技術非常重要。 稍微快轉幾百年, 我們發展出了微創或關節鏡手術, 結合了影像技術和精準的工具 來降低手術的侵入性。 更近期,許多人 可能聽過機器人手術, 機器人學帶給手術的 是類似現代自動化機械裝置、 超精度、 進行最小精準度手術的能力, 比人類雙手能達到的精準度更高。 但,機器人手術還為手術 帶來了一個新想法: 外科醫生不見得 一定得要站在病人的床邊進行照護, 他可以看著螢幕, 透過電腦來指示機器人進行。 我們稱之為遙控手術。
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.
我們有責任要找到成本效益高 又可擴展的方法來解決這些答案, 才能讓每個人, 不論在世界的哪個角落, 都能處理這些問題。
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.
如果我告訴各位, 並不需要一台造價百萬美金的機器人 也能做到遙控手術,如何? 你只需要一隻手機、 一台平板電腦或電腦、 網路連線、 一個有信心的同事在手術室裡, 還有一項魔法成份: 擴增實境協同作業軟體。 用這個擴增實境協同作業軟體, 專業外科醫生就可以用 虛擬的方式將他自己 傳送到任何臨床場景中, 只要用他的手機、平板或電腦即可, 他可以在一次手術中, 從頭到尾,做視覺上 和實際上的互動, 一步一步引導和指導 當地的醫生完成手術。
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.
各位應該聽我說夠了, 現在讓我來展示給各位看。 我們現在要跟馬克湯普金斯 醫生做現場連線, 他是明尼蘇達大學的整形外科醫生。 他將為我們進行一項關節鏡手術, 膝蓋的微創手術, 我想要公開說明, 這位病人同意讓這次的 手術影片被傳輸過來。 我也要先說明,因為時間的緣故, 我們只會做前面幾個步驟, 給病人做標記, 以及找出幾個關鍵的解剖學位置。 哈囉,湯普金斯醫生,聽得見嗎? 馬克湯普金斯醫生:早安,娜汀。
Nadine Hachach-Haram: Everyone from TED says hello.
娜汀哈恰奇哈蘭: TED 的大家說哈囉。
Audience: Hi.
觀眾:嗨。
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.
娜汀:好,湯普金斯醫生, 我們開始吧。 我們先從切口開始, 而切口的位置是在膝蓋肌腱的兩側。 如果你能在那裡和那裡做切口, 希望那樣能讓我們進入膝蓋。
MT: All right, I'm going in.
馬克:好,我要進入了。
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.
娜汀:很好。 我們現在進入了關節內部。 我們何不繞過去 快速看一下半月軟骨。
MT: Perfect.
馬克:好極了。
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.
娜汀:很好,所以我們能看到 半月軟骨上的這裡有個小撕裂傷, 其他地方看起來都還好。 如果你轉動一下,朝向這個方向, 跟著我的手指, 咱們來快速看看 前十字韌帶跟後十字韌帶。 那是前十字韌帶,看起來很健康, 那裡沒問題。 我們剛剛已經看到了那邊 半月軟骨上的小撕裂傷, 此外,關節周圍的液體 看起來也沒問題。 好的,非常謝謝你的時間, 湯普金斯醫生。 我就讓你繼續了。 祝今天愉快,再見。
(Applause)
(掌聲)
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.
我希望透過這次簡單的展示, 能夠向各位說明 這項技術能有多強大。 我要強調,我沒使用任何特殊裝備, 只有我的筆記型電腦 和很簡單的網路攝影機。 我們非常習慣使用數位技術, 透過聲音、文字、影像做溝通, 但擴增實境能做的事更深許多。 它讓兩個人能夠 以虛擬的方式做互動, 模仿他們面對面時的協同作業方式。 能夠讓對方知道你想要做什麼, 能夠圖解、展示、用動作示意, 遠比單單告訴對方要強大得多。 它能成為非常棒的學習工具, 因為直接經驗能讓學習更有效。
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,這要如何 在世界各地造成不同? 回到我的教學醫院, 我們一直在用它來支援 當地的地方綜合醫院, 提供皮膚癌手術以及創傷治療。 病人只要在地方的層級 就能取得照護。 這樣能減少他們的交通時間, 改善他們的使用, 還可以省錢。 它甚至開始被用在護士的 傷口照護管理上, 以及門診病人管理。 最近,很讓人興奮的是, 它被用來支援一位外科醫生, 進行癌症的腎臟切除手術。 我想快速和各位分享一下影片。 很抱歉會有一些可怕的畫面。
(Video) Doctor 1: OK. Show me again.
(影片)醫生 #1: 好,再讓我看一次。
Doctor 2: If you see here, that's the upper part, the most outer part of your tumor.
醫生 #2:你看這裡, 那是上半部, 你的腫瘤最外面的部份。
Doctor 1: Yes.
醫生 #1:是的。
Doctor 2: So it's three centimeters deep, so this should be three centimeters.
醫生 #2:它的深度有 3cm, 這應該是 3cm。
Doctor 1: Yes, yes.
醫生 #1:是,是的。
Doctor 2: OK, so you need to get a 3.5 margin.
醫生 #2:好,所以你得要 切除 3.5 公分,餘地才夠。
Doctor 1: I'm going to show you anyway and tell me what you think about it.
醫生 #1:總之,我會做給你看, 告訴我你認為如何。
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."
娜汀:我們也看到這項技術 被用到全球的規模, 我所記得最暖心的故事之一, 來自秘魯利馬北邊的楚黑歐小鎮, 當這項技術被用來支援 孩童的唇裂與顎裂手術, 幫助來自貧窮背景 且沒有健康保險的孩童。 在這小鎮有一間醫院, 只有一位外科醫生 很努力在提供這項照護, 索瑞亞醫生。 索瑞亞醫生很辛苦, 因為當地人口的需求太大了, 且她本身並沒有特別 受過這項手術的訓練。 所以,靠一個慈善團體協助, 我們得以讓她和加州的 一位唇裂外科醫生連結上, 用這項技術,他能夠 指導她和她的同事 一步一步完成手術, 引導他們、訓練他們、教導他們。 幾個月之內, 他們能夠進行的手術 數目多了 30%, 且併發症也越來越少了。 現在,索瑞亞醫生和 她的小組有足夠能力 能獨立且有信心地進行這些手術。 我記得有位母親說過: 「這項技術把微笑帶給我的女兒。」
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.
對我來說,這就是 這項技術真正的力量。 美好之處在於它跨越了國界。 它超越了所有技術困難。 它把人連結在一起, 讓大家都有使用機會。 無線上網和行動技術正在快速成長, 它們應該要在推動 手術提供上有所貢獻。 我們曾經看過它被用在 衝突地區,在那裡, 要專業外科醫生送到 某些特定地點是很危險的。 在這個世界上, 手機數比人類數還多, 它真的能觸及全球。 當然,還有很長的路要走, 才能解決要把手術 帶給五十億人的問題, 不幸的是, 有些人還無法取得網路連結。 但,現狀正在快速 朝正確的方向發展。 改變的潛力就在那裡。 我和我的團隊在全球 留下越來越多的足跡, 我們才剛開始看到這項技術的潛力。
Through digital technology, through simple, everyday devices that we take for granted, through devices of the future, we can really do miraculous things.
透過數位技術, 透過被我們視為理所當然 的簡單日常裝置, 透過未來的裝置, 我們真的能做出很了不起的事。
Thank you.
謝謝。
(Applause)
(掌聲)