Here is the link to the podcast of my interview at the Global AAGL congress– we discuss my vision for the coming radical transformation of surgery. For now the society requires you to (free) register to listen. The interview is at the bottom of the podcast section under AAGL 35th Annual Meeting Presents: Ways of Seeing: Dr. Steven Palter: Future Vision, Micro-Invasive to Non-Invasive Surgery.
Everything we do is set to become obsolete…
Ok I could not resist. I will posting a series of examinations of my vision for the post-endoscopy future. One of the key developments I forsee are miniaturized self-contained imaging (and then terapeutic) robots. Crazy you say! Well an Israeli compnay has just gone one step further towards realization. As medgadget reported
Israel21c interviewed Dr. Moshe Shoham from Haifa’s Technion, who claims the development of a novel propulsion system for a miniature robot, expected at first to swim through cerebrospinal fluid in the central nervous system, and then, possibly, through other fluid-filled cavities for diagnostic purposes.
The Univesity profiles it here.
I just came back from the AAGL 35th Global congress on Gyn Endoscopy where I gave a general session lecture on just this very concept. Fantastic voyage is coming. oday there are pill-cam capsules you swallow. Tomorrow the MArs rover makes a local stop in your gut. Much much more on this topic to come in the next few days….
Modern materials are enabling engineers to take a fresh look at the idea of aircraft that can flex, twist or change shape to make them more maneuverable. NASA and the Defense Department are funding research programs to explore ideas.
Scientists hope to gain a better understanding of the basic physics of the components and subsystems that will be needed for the next generation of aircraft. The research includes evaluating flexible-skin concepts that have been proposed to enable wings to change shape, improving tools for simulating how morphing structures behave in flight, and looking at using devices within the wing skins to recover or “harvest” energy as the wings move.
I have toyed with a concept like this for years for surgical endoscopy tools. I can imagine two scenarios:
1) first is the concept of assembling tools inside a body cavity. I first thought of this when I was developing tools for microlaparoscopy (surgery with 2mm instruments) in the mid-90′s. Since I could not get many instruments I needed in that size we thought about somehow assembling them inside the body
2) a morphing instrument just like these aircraft. We are so fixated on static instruments. There is no reason we should think so conventionally. Why not develop an instrument that can change its configuration to meet different needs.
Just like the transformers surgical tools can be mutifunction in the future.
I previously reported on BrainGate-the neural interface that connected a paraplegic’s brain to a computer for cursor control. Researchers at Wash U have reported a sytem that uses surface electrodes to provide similar function.
“With approval of the patient and his parents and the Washington University School of Medicine Institutional Review Board, Leuthardt and Moran connected the patient to a sophisticated computer running a special program known as BCI2000 (developed by their collaborator Gerwin Schalk at the Wadsworth Center, New York State Department of Health in Albany) which involves a video game that is linked to the ECoG grid. They then asked the boy to do various motor and speech tasks, moving his hands various ways, talking, and imagining. The team could see from the data which parts of the brain and what brain signals correlate to these movements. They then asked the boy to play a simple, two-dimensional Space Invaders game by actually moving his tongue and hand. He was then asked to imagine the same movements, but not to actually perform them with his hands or tongue. When he saw the cursor in the video game, he then controlled it with his brain.”
The boy, a 14-year-old who suffers from epilepsy, is the first teenager to play a two-dimensional video game, Space Invaders, using only the signals from his brain to make movements. Getting subjects to move objects using only their brains has implications toward someday building biomedical devices that can control artificial limbs, for instance, enabling the disabled to move a prosthetic arm or leg by thinking about it.
I also reported on the monkey with a direct link info here.
In the big picture this is another variation of alternative control systems. I often speak of “gesture controled surgery” where gestures are converted by video to task controls for surgery. This another way to potentially control surgical taks without traditional hands or instruments.
Are you ready to finally assemble your home theater? You’ve got all the elements picked out: the screen, the sound system — and a big projector. Well, if you really want the most awesome projector out there, you may want to head on down to Kentucky, where two university engineers, Christopher Jaynes and Stephen Webb have just built a 27 foot x 15 foot projected seamless display that shows 60 million pixels. As The Courier-Journal reported: “Building such a high-resolution display would normally cost millions of dollars, but Jaynes and Webb crafted the device from $100,000 in computers and projectors available at Best Buy and Circuit City.” The alleged “world’s highest resolution seamless display” is currently on public exhibition at the Galt House Conservatory in Louisville, Kentucky through Saturday (it’s free, so bring the kids), where there will be a rotating collection of images. These will include photographs from inside the space shuttle cockpit (you’ll be able to read the instruments), to snaps from the Hubble Space Telescope, to even extremely high-resolution imagery from the National Weather Service. Jaynes and Webb will also be on hand taking questions from visitors, so if you want to proposition them to see if they can incorporate one of these screens into your home — just remember to bring as much cash as you can carry.
REminds me of the military cave- I envision some version of this in the OR in the future instead of the myriad scattered displays we now have for endoscopy. True immersion.
This sucker spins webs.
Medgadget reports on a review of uses of spider silk. All kinds of neat potential spider-tech uses are mentioned in the article they quote.
“Dr. Randolph V. Lewis from the Department of Molecular Biology, University of Wyoming, wrote a great review article about spider silk and its multiple possible uses for biomed industry. From the press release that features an interview he gave to the American Chemical Society”
This article does not mention my favorite scary mutant spider product “biosteel”. I origially heard about this from a talk I attended at a medical meeting by a rep from DARPA (who have a hand in all things amazing and terrifying). Biosteel is a product made with transgenic technology by Nexia Biotechnologies. In short, the gene for spider-dragline-silk (the long toughest but non-sticky thread they use to drop to the ground in emergencies) has been transfected into goats. Yes goats. Then these mutant genetic chimera animals excrete the spider silk protein by the bucketful in their milk. Yes its true.
The company reportedly has been having difficulties spinning the stuff into usable forms and progress as been behind schedule. You can imagine where this (and the DARPA connection) is going – flexible wearable armor made of the strongest fabric even known. Spiderman did not need Kevlar.
In medicine, there are many potential uses I can imagine- all kinds of joint and tendon replacements, ligaments, heart valves, cut-proof surgeon gloves, etc. See my follow-up post on the technology behind this and how it can be used to make a spider-man.
Gizmodo reports on teleportation experiment. What more can I say! They write
“Scientists in Copenhagen took one more step toward the Star Trek transporter, figuring out how to teleport groups of billions of atoms from one place to another using light, quantum mechanics, magnetism and a concept they call “entanglement.” Professor Eugene Polzik and his team managed to move an object about 18 inches, using an excruciatingly complicated process that amounts to some serious magic.”
“Creating entanglement is a very important step, but there are two more steps at least to perform teleportation. We have succeeded in making all three steps — that is entanglement, quantum measurement and quantum feedback.”
Tom Cruise Minority Report Raytheon Army Version
In my last post on Fogscreen I shared my vision for a future of alternative display technologies opening up new options for surgical imaging. Let me elaborate on what I have called the “hand gesture control” concept. In traditional surgery there is a direct interaction between surgeon and patient. Laparoscopy (“keyhole surgery”- my specialty) is the revolutionary breakthrough where for the first time there is a technological interface between surgeon and patient. I believe this is a radical enabling step since this interface can now be modified endlessly by technology. Today we remain shackled by the surgeon using his hand to manipulate the tools. The DaVinci robot was one of the first steps whereby the direct line of touch between surgeon and patient has been interrupted by a computer controlled interface.
We should further explore the possibilities of the hand gesture system. Fogscreen employes this in their interactive version where you write with your finger like a cursor in space and the lines appear where you gesture. Clearly, a computer and camera system track movements and convert them into cursor paths. First shown in Minority Report, Tom Cruise gestures in space and pulls, pushes, and manipulats computer images projected in space. Wll folks, prototypes of this already exist. Raytheon has developed one for the army (they get all the good stuff first)– but the concept directly applies to surgery. Project an image in space- gesture with hand – direct laser or robotic tool- it opens up endless possibilities for free form and novel operative procedures and I predict it will be a major concept for future surgery.
Projection image Close-up of fog projector
I have a series of Nextfest updates coming. These are the first of my photo/video reports. An outstanding show at the Javits Center in NYC fromWired with advances in technology and cutting edge developments. The first impresion is the fogscreen display overhead as you pass into the exhibit hall. Fogscreen generates a water vapor mist with ultrasound (like an ultrasound humidifier) and then projects videon onto the mist-like screen. Ok Doc cool but isn’t this just a party trick why sould we care? The more intriguing aspect (besides the techno club rave entrance) is that this is one of the first commercialized alternative video display technologies. I have been speaking for years that I envision future endoscopy and medical imaging to employ several alternative display technologies. Today we are using just CRTs, LCDs, and the occasiaonal HMD (head mounted display). Thinking outside the box a bit — if we can transform the imaging display then we can create new funtionality. I envision augmented reality displays joining live visio with projected images. Just as fogscreen images on moving water vapor we could someday image on living tissues. Interactivity has been added by the fogscreen people for entertainment– you draw with your finger in space and the computer “sees” and interprets where you are. The same could be done for surgery by pointing and drawing in space. Remember Tom Cruise’s hand movements directing the image recalls in Minority Report… Its coming…
Several reports of Claudia Mitchell first woman with bionic arm from the same people who brought you the other bio arms– Rehabilitation Institute of Chicago and DARPA.