I previously wrote about the upcoming National Geographic Special Inside the Living Body and my work featured in the special. I was delighted when the producers of 20/20 called to request an interview with me on my research featured on the show and my vision of the future technological transformation of medicine.   Bob Brown was interested in coming to interview me.  They have already posted a description of the upcoming interview and a summary of the show. 

They call it an “Unprecedented Journey Inside the Living Body- ‘We’re Seeing Things That We Had Never Seen Before,‘ Says Scientist (that’s me).

On their website they write:

Recent technological advances have allowed for such dramatic and amazing views of the inside of our bodies that watching the footage can feel like you’re in a science fiction film or on an imaginary expedition…In such a science fiction journey, the 1966 film “Fantastic Voyage,” a group of scientists and their submarine were miniaturized so they could be injected into a body in order to eliminate an otherwise unreachable brain clot.

“I use clips from that movie when I lecture about these new technologies,” said Dr. Steven Palter, the medical and scientific director of Gold Coast IVF in Syosset, N.Y. “Now, physicians can actually see the workings of the body and understand it in a way that they never could before.”

Palter, who has a medical technology blog called docinthemachine.com, is a pioneer of methods capable of producing spectacular high-definition surgical images.  Palter obtained his footage by advancing well-established procedures that allow doctors to insert cameras through small incisions and view the target areas of their surgeries. He successfully hooked up high-definition cameras and, he said, was awestruck by the results.

“With high definition, we’re seeing things that we had never seen before … with depth perception, clarity and detail … because now it’s enormously clear and magnified. We have views that you don’t get with your naked eye.”

They also write about my autofluorescent laparoscopy research: “New Way of Seeing Ourselves”

The technology used for the National Geographic Channel is also clearly on its way to helping revolutionize medical care. Palter contributed to the development of what’s called an auto-fluorescent laparoscope, which exposes diseased tissue inside the body that a surgeon couldn’t otherwise see.

“Instead of using visible light, it makes the disease fluoresce,” Palter said. “If you look with your naked eye, you see nothing. When you switch on the light and the filters, all of a sudden the disease is glowing green, and you can see disease that’s beyond the resolution of your naked eye.”

The setup

Details and Insights from the Interview: It really was an amazing morning.  I have done countless interviews and seminars with the media over the years and this really stood out for me.  Perhaps most enjoyable was the genuine interest and fascination with the topic of their correspondent Bob Brown (who was also a first rate nice guy).  They showed up at 8AM and took 1.5 hours to dismantle my office and set up the lighting.  We started extra early with the fertility patients that day so they could be finished and out the door before the TV crew came in to protect their confidentiality and to not make them feel uncormfortable (always a key issue in my fertility practice Gold Coast IVF).

Directing the shoot

The cameras and the Crew:  Being the techno videophile guy that I am I jumped at the chance to talk with independent film crew brought to shoot me.  They had 3 cameramen/directors and there were 2 producers from 20/20, Bob Brown the correspondent, and a media relations rep from National Geographic (in case questions came up about their part).  They set-up a 2 camera shoot in my office with blazingly hot spot lights to ensure I would be nice and sweaty on camera.  They shot in standard BetacamSP.  Of course I could not resist to ask them why they did not shoot in HD.  They answered that the news shows inthe studios shoot in HD but that in the US all field work is done in SD.  This is because there are countless freelancers and crews out there all using different equipment and all waiting for some semblance of an HD standard to evolve before they invest hundreds of thousands of dollars in new HD cameras and editing and risk it being the “wrong format”.  Wow- how similar to the confusion in the medical and consumer video sectors! I continued my fact-finding quest and asked about who was using what systems and the relative advantages of each- panasonic sony JVC image sensors, color fidelity, native chip resolution tape vs disk vs solid state recording editing etc etc all trying to gleam insights I could take back to medicine and the OR. 

Showing Bob Brown (and cameraman) a Laparoscope  

The interview and turning the tables:  Bob interviewed me for 2.5 hours until they ran out of film. I was excited to share my excitement and passion for the subject of the future of medicine and surgery and how my work fits into this vision.  Bob was interested in the medical technology behind the show.  He asked a very wide range of questions from how I thought to merge HD video and surgerr back in 1999 to what I think is more beautiful - the earth from space or the vista of the internal human organs, to how will we pay for these new technology developments.  He was interested in everything I was working on and what I thought would have the most impact.  We discussed robotic assited surgery, natural orifice surgery (NOTES), augmented reality and head mounted displays, surgical simulators for training and the potential for real-dataset preoperative practice, virtual colonoscopy and 3D/4D ultrasound etc etc.

I had a chance to turn the tables a bit and ask him why they chose this topic and how they felt it would appeal to the lay public.  He told me that TV shows like 20/20 they basically track viewers interest levels minute by minute as they shows air.  He added that the medical pieces they ran have huge audience ratings and the more real the higher the appeal.  We discussed how the netorks know that on shows like CSI it is often the medical technology that draws the audience in.  He has a special talent in reporting human interest segments and has an amazing ability to distill down the high tech medicine we discussed and share with non-medical viewers how it will affect their lives. 

Sharing the footage:  After the interview he wanted to watch some of my HD surgical footage that I shot for National Geographic with the true HD 1080 16:9 system which I fortunately had available on HD XDCAM with a Sony ultrahigh resolution 24″ LCD HD monitor. Both the 20/20 people and the video crew were amazed by the resolution of the images and one of them remarked “If I need surgery I want them to use that“   Being video people the film crew and director’s understanding of the power of HD in the OR was immediate when they saw just a few seconds of the images.  I continue to have the same degree of awe and fascination each time I operate with these systems.

Bob Brown was especially interested in my research on the development of autofluorescent laparoscopy and my concept of “FutureVision“- where surgical technology surpasses inate human senses and we watched those videos as well.

They finished off with few minutes of B-roll footage of Bob and I walking and talking in front of the hospital and requests for room cam OR footage and my AF surgery footage(all of which I was happy to share with them).

Bob Brown, the Producers, and the docinthemachine

The 20/20 show airs this Friday September 7th at 10PM on ABC- check it out!

The BBC is reoprting that a new geneticaly medified mosquito has been created that is relatively reistant to malaria. 

The study publsihed in PNAS reports

The approach exploits the fact that the health of infected mosquitoes is itself compromised by the parasite they spread. Insects that cannot be invaded by the parasite are therefore likely to be fitter and out-compete their disease-carrying counterparts.

BBC says;

The organism is passed to humans through the bite of the Anopheles mosquito. Each year it makes 300 million people ill and causes a million deaths worldwide.   Some 90% of cases are in sub-Saharan Africa, where a child dies of malaria every 30 seconds.

Before you spill all of your quinine out, the malaria variation tested was a rdent one and the researchers predict tit will be 10-20 years before GM mosq’s will be released into the wild.

Many people do not realize that the gene for sickle cell anemia functions in a similar fashion.  While deadly in its full disease form, the carrier state (or sickle cell trait) confers a relative immunity to malria and is likely the reason this genetic variation is so common in the Africal population.

While on the subject of GM mosquitos there have been frankencreatures and frankenpets before that have a fluorescent gene stuck into their genome.

The most famous is Glofish.  For more info - Here’s how the fluorescent glofish are made.  Nothing like genetic engineering to create cute pets.  Hey why not knock out growth hormone so you kitten never grows up!

Grand Rounds 3.25 is up over at Scienceroll.  A gret blog I have mentioned before it is run by Bertalan Meskó, a Hungarian Medical Student wit a passion for genetics.  Definitely worth checking out there are about 60 posts but excellently organized in categories to make the reading clear and quick.  A nice variety.

I am honored that he chose two submissions from docinthemachine (one I submitted and one submitted by somemone else!).  There are links to my posts on :

docinthemachine’s first podcast on the coming technological revolution in surgery (in a new web 2.0 section of grand rounds )and also on new regulations to spread information and increase post marketing surveillance of drugs from the FDA

Another exclusive docinthemachine first. Here is a link to view the prize winning video of my research on the development of an autofluorescent endoscopy system. The details of the research can be found here.

This research was honored with awards at the recent annual meetings of the AAGL (American Association of Gynecologic Laparoscopists), ASRM (Americal Society for Reproductive Medicine) , and SLS (Society of Laparoendoscopic Surgeons).

This is yet another example of what I call “Future Vision - The Coming Radical Transformation of Surgery”

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Details of the Project:

The new “keyhole” surgery technique enables surgeons to see tumors and other pathologies, including endometriosis not otherwise visible. In traditional laparoscopy, the telescope provides the same view as would be seen with the naked eye. In the new method, highly specific filters are incorporated into the light system and telescope so that surgeons can see the tiny amounts of fluorescent light that all living human tissues give off when illuminated, a phenomenon called “autofluorescence”.

The system illuminates tissues with short wavelength blue light (380-450 nm). The tissues absorb this light and then release it as longer wavelength green light (>470 nm).

Normal and diseased tissues give off different amounts of light. Areas of disease that block fluorescence are seen as dark indigo areas, whereas those that emit fluorescence glow like a firefly. With this new surgical technique I can see disease that is otherwise invisible and treat the patient more effectively.

My study reported on the use of the autofluorescence system for the diagnosis of endometriosis, a potentially debilitating disease that affects 5.5 million women in the United States, causing infertility and chronic pelvic pain. We found additional disease using the system in 63% of the women with endometriosis examined