of the future
robotic doctor and virtual patient. Chips in the hip and gamma
knives. These advances in medicine that boggle the imagination
have computers playing an intrinsic role"
have seen more advances in medical science in the last 50
years than ever before. Our worlds transformed in way that
surpass the wildest imagination. Technology that exists today
was unthinkable in the 1950s. Is it possible to even predict
the technology 25 years hence? Where will the techno-human
evolution lead us in the next millennium?
Your Body, Your Mind
abdomen, the chest and the brain will forever be shut form the
intrusion of the wise and humane surgeon,” said sir John
Eric Erickson, British surgeon appointed to Queen Victoria in
the Year 1873.
how wrong he was! Medical science has grown by leaps and
bounds since then. Now, it is considered routine for doctors
to conduct delicate surgery using lasers. Fiber-optic cables
connected to video cameras permit them to see inside the body
and operate through tiny holes in the skin without even
cutting the skin. Open-heart surgery had caught the world’s
imagination when it was first conducted. Today, a
revolutionary new system is set to take on the medical world
have begun testing a robotic surgery procedure in the United
States that could get heart surgery patients back to work
within days instead of weeks. The new system combines robotics
and computer imaging. It allows doctors to perform heart
surgery by controlling miniature hands inside the chest cavity
through one-centimeter incisions. The robotic hand is allowed
seven degrees of freedom of movement at the wrist, Just like
the human wrist, and is wonder fully ergonomic. Since
incisions are minute compared to those made in traditional
open-heart surgery, doctors expect patients to have a shorter
recovery time and suffer significantly less pain. Surgeons
control the robotic appendages with joysticks and watch their
progress via a 3-D computer image.
not unlike surgery; however in this case, the surgeon is
always in absolute control of the machine as well as the
operation. The advantage of this amazing technology is that in
a matter of days the surgeon can learn the procedure.
does seem that genetic engineering, biometric chips,
incision-free and robotized surgery will become conventional
in the years to come.
And Gamma Knife Radiation
yet another development, surgeons
are using new imaging software to develop gamma radiation
treatments that take the place of painful and risky cranial
incisions for tumour removal and other brain treatments.
transfer the images taken by MRI over the hospital’s network
to a treatment planning workstation, where scientists work out
the computationally intensive math to come up with coordinates
for the surgeons to target.
the past, the processing might have taken hours or days, so
the types of surgery that could be done were limited. More
recently, with the newer computer software and real-time
treatment planning doctors are being able to design treatments
can now view the lesion on the MRI and directly develop a
treatment plan targeted at the lesion, preserving the
surrounding normal brain structures. Doctors can treat brain tumors
and other disorders with a pain free, outpatient operation
using the so called gamma knife.
treatment can last from several minutes to several hours depending
on its complexity and number of individual targets. The gamma
knife emits 212 beams of Cobalt-60 gamma rays. The surgeons
and physicists program the machine so the radiation will hit
one spot, within a fraction of a millimeter , anywhere inside
traveling separately, the 212 beams travel through other parts
of the brain without causing damage. When they converge at the
desired spot, however, they deliver a high dose of radiation
that achieves a clinical effect. The gamma knife causes no
pain, allowing adult patients to comfortably stay awake during
surgery is still preferred and necessary in some cases. But,
now for many conditions such as arteriovenous malformations
(AVM), gamma knives are becoming the first line choice. This
is the surgery of the future.
Artificial Human And Artificial Surgeons
crash-test dummies have been used for years in auto
collisions, a new type of dummy called medical test
dummy has found its way into hospitals and is being
used for drug testing.
as robots assist experienced doctors in delicate surgery,
doctors fresh from medical school find themselves training on
a medical test dummy. It seems as if the human hand might not be
necessarily perform delicate surgery in the future; and
neither would the body part being operated be made of human
tissue. Sounds absurd, but even as you read this, researchers
at Penn University, USA are in the final stage of developing
the first artificial patient.
full sized computerized patient simulator can develop many
physiological complexities and diseases. It is also programmed
to react to 50 different drugs used by humans in just the same
way. Any monitor that could potentially be hooked up to a real
human can be hooked up to the mannequin. Since the dummy has a
heart with a pulse that can be felt in the neck and arms, it
produces the same electrical pulse output as humans do, which
enable an ECG monitor to record the signals.
human mannequin’s chest heaves as lungs consume oxygen and
produce carbon dioxide. Through the speakers, you could listen
to the lung sounds. The dummy not only helps medical
practitioners in their studies, but also could reduce the use
of animals in drug testing trails.
who have never seen the real side effects of a slow heart
rate, would prescribe medication to speed it up; however, this
may not be good for the patient. But with training, the
physician can accept a drop in heart rate, knowing it will
come back in a minute or two.
dummy is equipped with a barcode reader, so you can input more
than 50 different drugs. It will recognize the drugs, and weigh
the amount of fluid administered; it is programmed with math
models that will calculate blood pressure, respiration, and so
has spawned technologies that have transformed the world in
the past five decades. It is fast blending with the science of
life. Future trends will see man and machine in a perfect mélange
of intrinsic and extrinsic qualities of both worlds.
microchip technology has led to the creation of an advanced,
implantable insulin pump that may eventually free diabetics
from troublesome daily insulin injections. Algorithms have
been recently developed which are small enough to fit on a
tiny silicon chip that can monitor and control blood-sugar
microchip could be embedded in a surgically implanted insulin
pump that could release insulin as needed and be refilled
monthly. The system closely controls blood sugar levels in
type I or insulin-dependent diabetics by continuously
predicting the patient’s need for insulin. The algorithm
would analyze glucose readings from a sensor and instruct the
mechanical pump to deliver the appropriate dose of insulin to
device is likely to be placed near the left hip, close to the
portal vein, where the pacers normally releases insulin into
the blood stream. The surgery
to implant the pump would be a complex procedure but
beyond that the device would be designed for easy maintenance.
Refills of the pump’s insulin reservoir would probably
require a monthly outpatient injection.
devices based on powerful microchips could play a major role
in the development and support of the human being, which could
result in the formation of a cyborg or a bionic man.
new computer-assisted process could help radiologists minimize
the margin of error in mammogram screenings. The technology is
designed to complement standard mammography film into a
digital signal that can be analyzed by a computer.
“pointers” on a video screen, the computer alerts
radiologists to small clusters of micro calcifications and
tiny clusters of cell that could
be the early stages of cancer. Preliminary tests based
on a study of 104 mammograms have found that the computer can
find some cancers that doctors might have otherwise missed.
But researchers caution that future studies are still needed
to determine the accuracy of the tool.
trials of the Image Checker demonstrated that for every
100,000 breast cancer currently detected, use of the tool
could result in the early detection of an additional 12,800
cancers each year.
of CT scans
have developed software and a central database that would
allow doctors to make comprehensive image comparisons of
medical cases within seconds. Content based image retrieval
would allow doctors to compare the results of high-resolution
CT scans to diagnoses and treatments of similar cases world
like a keyword search, where a query when posed does a search
through the database. Only here its done with CT-scan images.
Here’s how it works: A physician uses a mouse to identify up
to five diseased regions on a patient’s image, then submits
the picture in the form of a database query.
software applies a series of image-processing algorithms to
characterize the region and compares it with other images in
the database. The physician receives four pictures from the
database, which can be enlarged, isolated, enhanced, and
cross-sectioned. Doctors would also have access to the
treatment histories of the database cases to aid in making a
the database contains only scans of
human lungs, but researchers hope to eventually include
MRIs of the knee, liver and brain.
system is designed to help doctors who are unfamiliar with
certain diseases make more informed diagnoses. Normally,
radiologists must sift through large books of compiled CT
scans in order to compare cases. But the new retrieval system
allows computers to analyze images in ways that once required
the seasoned eyes of skilled radiologists.
the continuing technological explosion will bring the
eradication of many diseases. It will also usher in an era of
lifelong learning, broad access to information resources and
maybe even virtual vacations on earth and space.
we will witness in our lifetime could be the evolution of a
new breed of medical treatment. The new generation who are in
medical school or in the research domain will play an
important role in shaping the world of tomorrow. And advancing
towards it will be every bit as exciting and full of surprises
as the last five decades have been for the medical community.
Copyright © 2002 Dr. Subrahmanyam