after lap surg mayo 0207 optimized

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Disruptive Visions

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Current Visions

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Fundamental Concept

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Holomer Total body-scan for total diagnosis Satava March, 2004 From visible human to Virtual Human Multi-modal total body scan on every trauma patient in 15 seconds

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Virtual Autopsy Less than 2% of hospital deaths have autopsy Statistics from autopsy drive national policies

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Why robotics, imaging and modeling & simulation Healthcare is the only industry without a computer representation of its “product” A robot is not a machine . . . it is an information system with arms . . . A CT scanner is not an imaging system it is an information system with eyes . . . thus An operating room is an information system with . . .

Total Integration of Surgical Care: 

Total Integration of Surgical Care Courtesy of Joel Jensen, SRI International, Menlo Park, CA Minimally Invasive & Open Surgery Pre-operative planning Surgical Rehearsal Intra-operative navigation Remote Surgery Simulation & Training Pre-operative Warmup

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The Fundamental Changes From tissue and instruments to Information and energy* E = i c 2 * “The Information Age is about changing from objects and atoms to bits & bytes” Nicholas Negroponte “Being Digital” - 1995

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Disruptive Visions

The Information Age is NOT the  FutureThe Information Age is the  Present ...There is something else out there . . . . . .: 

The Information Age is NOT the Future The Information Age is the Present ... There is something else out there . . . . . . SATAVA 7 July, 1999 DARPA

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Scientific Method . . . . . . is DEAD? HISTORY Observation, Phenomenon Experiment Scientific method, …? Not all science is explainable using scientific method Intuition Creativity Quantum mechanics What comes BEFORE the hypothesis? Observation, phenomenon, experiment, scientific method, …? A new “science” may need to be invented

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Scientific Method A Paradigm Change? Hypothesis Study Design Experiment Results Reporting Hypothesis Study Design Modeling & Experiment Results Reporting Simulation Modeling & Simulation

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Clayton M Christensen

BIO INTELLIGENCE AGE: 

BIO INTELLIGENCE AGE TECHNOLOGY DEVELOPMENT CONSUMER ACCEPTANCE AGRICULTURAL AGE INDUSTRIAL AGE BIOINTELLIGENCE AGE INFORMATION AGE Satava 29 July 99

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BIOLOGIC PHYSICAL INFORMATION FUTURE Robotics HPCC/WWW MEMS/Nano Genomics Bioinformatics Biocomputation Biosensors Biomaterials Biomimetic Satava 2 Feb 1999 The BioIntelligence Age

The key to the future  is multi-disciplinary teams: 

The key to the future is multi-disciplinary teams

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¿And just what are these incredible new technologies?

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University of Montana, 1999

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University of Wisconson, 1999

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Biomimetic Micro-robot Courtesy Sandia National Labs Capsule camera for gastrointestinal endoscopy Courtesy Paul Swain, London, England Courtesy D. Oleynkov, Univ Nebraska

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Greg Kovacs. Stanford University, 1990 “BrainGate” John Donohue, Brown University, 2001 Richard Andersen, CalTech, 2003

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Courtesy Richard Andersen, Cal Tech, Pasadena, CA Brain Machine Interface – Controlling motion with thoughts Miguel Nicholai, Duke University, 2002 Direct brain implant control of robot arm

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a) Rheo Bionic knee Ossur, Reyknavik, Iceland b) C-leg Otto Bock, Minneapolis, MN Intelligent Prostheses

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Tissue Engineering Liver Scaffolding Artificial Blood Vessel J. Vacanti, MD MGH March, 2000 Artificial Ear

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Spider silk protein as biomaterial -BioSteel Nexia Biotechnologies, Montreal Canada Cross section of synthetic fiber Spinnerette of spider Orb spider - web

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Brian M. Barnes, Institute of Arctic Biology , University of Alaska Fairbanks 11/02 Suspended Animation ( Auto-anesthesia - FRAMR ) Alternative

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Confidential

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The rate of new discovery is accelerating exponentially The changes raise profound fundamental issues Moral and ethical solutions will take decades to resolve Technologies will change the Future

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Technology is Neutral - it is neither good or evil It is up to us to breathe the moral and ethical life into these technologies And then apply them with empathy and compassion for each and every patient The Moral Dilemma

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Genetically “designed” child 1997 Jeffery Steinberg, MD Fertility Institutes of Los Angeles Five "designer babies" created for stem cell harvest Five healthy babies have been born to provide stem cells for siblings with serious non-heritable conditions. This is the first time "savoir siblings" have been created to treat children whose condition is not genetic, says the medical team.The five babies were born after a technique called preimplantation genetic diagnosis (PGD) was used to test embryos for a tissue type match to the ailing siblings, reports the team, led by Anver Kuliev at the Reproductive Genetics Institute in Chicago, US.The aim in these cases was to provide stem cells for transplantation to children who are suffering from leukaemia 'Unlawful and unethical' However, the use of this technology to provide a "designer baby" to treat an ill sibling is highly controversial.A UK couple involved in this Verlinsky Y, Rechitsky S, Sharapova T, Morris R, Taranissi M and Kuliev A. Preimplantation HLA Testing. JAMA (2004) 29: 2079 Preimplantation Genetic Screening General Science: May 13, 2006   A British woman has become the first in the country to conceive a "designer baby" selected specifically to avoid an inherited cancer, The woman, who was not identified, used controversial genetic screening technology to ensure she does not pass on to her child the condition retinoblastoma, an hereditary form of eye cancer from which she suffers. Doctors tested embryos created by the woman and her partner using in-vitro fertilisation (IVF) methods for the cancer gene. Only unaffected embryos were implanted in her womb, the newspaper said. It suggested the woman's pregnancy would increase controversy over the procedure -- pre-implantation genetic diagnosis (PGD) -- because critics say it involves destroying otherwise healthy embryos whose conditions are treatable. Science Vol 315: 1723-25, Mar 2007 Emergence of Novel Color Vision in Mice Engineered to Express Human Cone Photo-pigment Changes in the genes encoding sensory recptor proteins are an essential step in the evolution of new sensory capacities“new sensory capacities" . In primates, tri-chromatic color vision evolved aftre changes in x chromosome linked photopigment genes. Heterogous mouse females human L pigments showed enhanced long-wavelength sensitivity and chromatic discrimination. An inherent plasticity in the mammalian visual system thus permits emergence whose retinas contained both mouse pigment and human L pigments

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Extending Longevity A strain of mice that have lived . . . . . . more than three normal lifespans Should humans live 200 years?

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Will Machines become “smarter than humans? Humans vs Machine Humans 4.0X10 19 cps Red Storm 3.5X10 15 cps Moore’ s Law “computer power doubles every 18 months” Do the Math !! Who is smarter now?? The Age of Spiritual Machines WHEN COMPUTERS EXCEED HUMAN INTELLIGENCE Should astronauts be provided with super-intelligent systems* * HAL of “2001: A Space Odeyssey

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The new face of “Hal” – emotional and affective robotics Courtesy David Hanson, Hanson Robotics, Austin, TX

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If I replace 95% of my body . . . . . . Am I still “human”? Artificial organs Smart Prostheses Genetic engineering Regeneration Should there be replacement “parts” for astronauts?

Moral and Ethical Issues Raised by Technological Successwill take DECADES of debate Summary of Examples : 

Moral and Ethical Issues Raised by Technological Success will take DECADES of debate Summary of Examples Should we do research in areas we may not be able to control? (eg, genetics, cloning, nanobots, intelligent machines?) Will prolonging life with technology result in more disease in the overall population Can we change medicine from treatment to prevention of disease In defeating diseases, will technology change a human into a combination of man and machine - what does it mean to be “human” How will we decide who gets the technology, especially in 3rd World SATAVA 7 July, 1999 DARPA 6

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For the first time in history, there walks upon this planet, a species so powerful, that it can control its own evolution, at its own time of choosing … … homo sapiens. Who will be the next “created” species? The Ultimate Ethical Question?

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Do Robots Dream ? http://depts.washington.edu/biointel