Portable ORs, using thoughts to control motions, and auto-anesthesia--these are some of the technologies that will transform the practice of cardiology.
Portable operating rooms (ORs), robotic doctors and nurses to man ORs, miniaturized robots implanted by the dozen to perform medical procedures, synthetic body tissues and organs, using thoughts to control motions, and auto-anesthesia — these are some of the available and future technologies discussed by Richard Satava, MD, a pioneer in robotics, during the 41st Annual Louis Bishop Lecture at the 59th Annual Scientific Session of the American College of Cardiology.
Why would cardiologists listen to a lecture that verged on science fiction? “You need to be aware of the available technologies and those that are coming. If they take you by surprise, it could ruin your medical practice,” Satava told listeners. He is professor of surgery at the University of Washington, Seattle, WA, and Military Advisor in Fort Detrick, Maryland.
Satava believes that although patients have unrealistic “superhero” expectations of their physicians, some of their expectations can be met by coming technologies. These expectations include an instant diagnosis, immediate treatment, no pain, and cure. “We are now in the information age, replacing tissue and instruments with information and energy” he stated. “We can do things that were previously impossible.”
Medicine currently lacks a computer model of the “product,” that is, the patient. “We are the only industry that lacks this model,” Satava commented. Scientists are on the verge of being able to create a computer model of the patient, he continued, showing slides of a personalized total body scan imprinted on soldiers’ dog tags. He predicted that visual autopsies of wounded soldiers will become a reality, providing more complete information than actual autopsies and inform policy-making in the military.
Some of these “sci-fi” techniques are currently available. For example, High Intensity Focused Ultrasound (HiFu can stop bleeding. “In the future, a medic could use HiFu to stop internal bleeding in car accident victim,” he noted. Another new technology, the FE-DBD insulated electrode, is “100% effective” in sterilizing tissues without supplies. “This could be inserted in a central line and prevent surgical infection,” he said.
The military has developed Life Support for Trauma and Transport (LSTAT), a portable ICU that can be brought to a wounded soldier in the field. Using telemedicine with the LSTAT, ventilation can be increased or reduced as can the delivery of parenteral nutrition. “LSTAT has been used since 2000 in the military and when surgery is complete, you have a complete record of the event,” Satava said.
Unmanned helicopters that work in concert with the LSTAT are being developed. The destination is typed in on a computer, and the helicopter is ready for the wounded soldier to be transported back to the base.
Using new technologies takes a concerted effort in skill training and surgical education. The American College of Surgeons and other surgical societies have mandated training requirements for some of the newer procedures, including endoscopies. “We can improve patent care through advanced medical education, focusing on safety,” Satava said.
He cautioned that moral and ethical dilemmas posed by new technology have yet to be fully explored. Advances such as cloning, genetic engineering to cure genetic defects, technology that can extend human life, and replacing body parts are examples of technologies with ethical implications.