TEDMED 2011
Yoav Medan: Ultrasound surgery -- healing without cuts
Yoav Medan: Ultrazvočni poseg -- zdravljenje brez rezov
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Predstavljate si operativni poseg brez skalpelov. Na TEDMEDu Yoav Medan predstavlja tehniko, ki kombinira slikanje z magnetno resonanco za odkrivanje obolelih delov z usmerjenim ultrazvokom, ki zdravi bolna tkiva kot so poškodbe v možganih, maternični fibroidi in različne vrste rakavih tvorb.
Yoav Medan - Medical inventor
With his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound. Full bio
With his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound. Full bio
Double-click the English transcript below to play the video.
00:15
Over the last 13 years --
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Zadnjih trinajst let,
00:17
one, three, 13 years --
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ena - tri, trinajst let,
00:19
I've been part of an exceptional team at InSightec in Israel
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sem bil del izjemne ekipe izraelskega zdravstvenega podjetja
00:22
and partners around the world
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InSightec in partnerjev po vsem svetu,
00:24
for taking this idea, this concept,
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s katerimi smo želeli idejo oz. koncept
00:27
noninvasive surgery,
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neinvazivnega kirurškega posega
00:29
from the research lab to routine clinical use.
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prenesti iz raziskovalnih laboratorijev v klinično prakso.
00:32
And this is what I'll tell you about.
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O tem vam bom danes pripovedoval.
00:34
13 years --
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Trinajst let --
00:36
for some of you, you can empathize with that number.
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nekateri bi z mano sočustvovali.
00:39
For me, today, on this date,
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Jaz pa danes, na ta dan,
00:41
it's like a second bar mitzvah experience.
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praznujem nekakšno drugo bar micvo.
00:43
(Laughter)
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(Smeh)
00:46
So this dream
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Te sanje
00:49
is really enabled
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smo uresničili
00:51
by the convergence
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z združitvijo
00:53
of two known technologies.
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dveh znanih tehnologij.
00:55
One is the focused ultrasound,
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Ena je usmerjen ultrazvok,
00:57
and the other one is the
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druga pa
01:00
vision-enabled magnetic resonance imaging.
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magnetna resonanca z vizualnim predstavljanjem.
01:03
So let's first talk about focused ultrasound.
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Začnimo z usmerjenim ultrazvokom.
01:07
And I hold in my hand
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V roki držim model,
01:09
a tissue-mimicking phantom.
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ki prikazuje tkivo,
01:11
It is made out of silicon.
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narejen iz silikona.
01:13
It is transparent, made just for you.
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Je prozoren in izdelan prav za vas.
01:16
So you see, it's all intact,
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Kot vidite, je čist
01:19
completely transparent.
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in popolnoma prozoren.
01:21
I'll take you now to the acoustic lab.
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Sedaj vas bom popeljal v akustični laboratorij.
01:24
You see the phantom within the aquarium.
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Tu vidite ta model v akvariju,
01:26
This is a setup I put in a physics lab.
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gre pa za postavitev v fizikalnem laboratoriju.
01:28
On the right-hand side,
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Na desni strani vidite
01:30
you see an ultrasonic transducer.
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ultrazvočni prevodnik.
01:32
So the ultrasonic transducer
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Ta ultrazvočni prevodnik
01:35
emits basically an ultrasonic beam
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oddaja ultrazvočni signal,
01:37
that focuses inside the phantom.
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ki se fokusira znotraj silikonskega modela.
01:40
Okay, when you hear the click,
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Ko zaslišite klik,
01:44
this is when the energy starts to emit
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se začne oddajati energija
01:46
and you see a little lesion form
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in vidite majhno sled,
01:49
inside the phantom.
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poškodbo znotraj modela.
01:52
Okay, so everything around it
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Vse okrog nje
01:54
is whole and intact.
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pa je ostalo celo in nedotaknjeno.
01:56
It's just a lesion formed inside.
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Poškodba tkiva je nastala le v notranjosti.
01:58
So think about, this is in your brain.
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Zamislite si, da so to vaši možgani
02:01
We need to reach a target inside the brain.
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in mi moramo doseči točko znotraj njih.
02:03
We can do it without harming any tissue.
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To lahko storimo ne da bi poškodovali ostalo tkivo.
02:06
So this is, I think,
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To je torej po mojem mnenju
02:08
the first kosher Hippocratic surgical system.
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prvi Hipokratov košer operacijski sistem.
02:11
(Laughter)
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(Smeh)
02:13
Okay, so let's talk a little bit about ultrasound,
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Naj povem nekaj stvari o ultrazvoku,
02:15
the force of ultrasound.
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o moči ultrazvoka.
02:17
You know all about imaging, right, ultrasound imaging.
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Vsi poznate ultrazvočne posnetke, kajne?
02:20
And you know also about lithotripsy --
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Poznate tudi litotripsijo,
02:23
breaking kidney stones.
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metodo drobljenja ledvičnih kamnov.
02:26
But ultrasound can be shaped
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A ultrazvok lahko predstavlja
02:29
to be anything in between,
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še marsikaj drugega,
02:32
because it's a mechanical force.
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saj gre za mehansko silo.
02:35
Basically, it's a force acting on a tissue
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V osnovi ta sila vpliva na vlakno,
02:37
that it transverses.
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na katerega je usmerjena.
02:39
So you can change the intensity, the frequency,
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Spreminjamo lahko jakost, frekvenco,
02:42
the duration, the pulse shape of the ultrasound
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trajanje, obliko ultrazvočnega signala
02:45
to create anything
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in tako ustvarimo karkoli,
02:47
from an airbrush to a hammer.
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od airbrusha do kladiva.
02:50
And I am going to show you
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Pokazal vam bom
02:52
multiple applications in the medical field
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različne možnosti uporabe v medicini,
02:54
that can be enabled
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ki jih omogoča
02:56
just by focusing,
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zgolj fokusiranje,
02:58
physically focusing.
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fizično fokusiranje.
03:01
So this idea
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Ta koncept uporabe usmerjenega ultrazvoka
03:03
of harnessing focused ultrasound to treat lesions in the brain
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za zdravljenje možganskih okvar
03:06
is not new at all.
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pa sploh ni nov.
03:08
When I was born, this idea was already conceived
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Ko sem se rodil, so se s to idejo že ukvarjali
03:11
by pioneers such as the Fry brothers
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pionirji, kot sta brata Fry
03:14
and Lars Leksell,
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in Lars Leksell,
03:16
who is know actually
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danes znan kot
03:18
as the inventor of the gammaknife.
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izumitelj gama noža.
03:20
But you may not know
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Morda pa niste vedeli,
03:22
that he tried to perform lobotomies in the brain,
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da je v petdesetih letih poskušal izvajati
03:24
noninvasively,
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možgansko lobotomijo na neinvaziven način
03:26
with focused ultrasound in the '50s.
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z usmerjenim ultrazvokom.
03:29
He failed,
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Ni mu uspelo,
03:31
so he then invented the gammaknife.
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je pa kasneje izumil gama nož.
03:33
And it makes you ponder
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To da človeku misliti,
03:36
why those pioneers failed.
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zakaj tem pionirjem ni uspelo.
03:40
And there was something fundamental
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Manjkalo jim je
03:42
that they were missing.
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nekaj bistvenega.
03:44
They were missing the vision.
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Manjkala jim je vizija.
03:46
It wasn't until the invention of the MR
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Šele z odkritjem slikanja
03:49
and really the integration of MR
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z magnetno resonanco (MRI)
03:51
with focused ultrasound
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in njeno združitvijo z usmerjenim ultrazvokom
03:53
that we could get the feedback --
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smo dobili odziv,
03:56
both the anatomical and the physiological
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tako anatomski kot fiziološki,
03:59
in order to have a completely noninvasive, closed-loop
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in tako ustvarili popolnoma neinvaziven,
04:03
surgical procedure.
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zaprtozančni kirurški poseg.
04:06
So this is how it looks, you know,
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Tako je torej danes videti
04:08
the operating room of the future today.
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operacijska soba prihodnosti.
04:11
This is an MR suite with a focused ultrasound system.
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To je prostor za MRI s sistemom usmerjenega ultrazvoka.
04:14
And I will give you several examples.
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Dal vam bom nekaj primerov.
04:16
So the first one is in the brain.
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Začnimo z možgani.
04:18
One of the neurological conditions
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Ena od nevroloških okvar,
04:21
that can be treated with focused ultrasound
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ki jo lahko na tak način zdravimo,
04:23
are movement disorders,
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so motnje gibanja, kot sta
04:25
like Parkinson's or essential tremor.
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Parkinsonova bolezen ali esencialni tremor (ET)
04:28
What is typical to those conditions,
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Za take motnje, kot na primer
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to essential tremor for example,
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pri esencialnem tremorju, je značilno,
04:34
is inability
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da bolnik ne zmore
04:37
to drink or eat cereal or soup
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piti ali jesti juhe ali kosmičev,
04:41
without spilling everything all over you,
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ne da bi se polil,
04:44
or write legibly so people can understand it,
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ali pisati dovolj čitljivo, da bi lahko za njim brali,
04:47
and be really independent in your life
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oz. biti v življenju neodvisen
04:50
without the help of others.
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in živeti brez pomoči okolice.
04:52
So I'd like you to meet John.
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Predstavljam vam Johna.
04:55
John is a retired professor of history
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John je upokojeni profesor zgodovine
04:57
from Virginia.
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iz Virginie.
04:59
So he suffered from essential tremor for many years.
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Esencialni tremor ga je zaznamoval mnogo let,
05:02
And medication didn't help him anymore.
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zdravila pa mu niso več pomagala.
05:06
And many of those patients refused to undergo surgery
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Veliko takšnih bolnikov je zavrnilo operacijo,
05:09
to have people cut into their brain.
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saj niso želeli posegov na možganih.
05:11
And about four or five months ago,
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Pred štirimi ali petimi meseci
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he underwent an experimental procedure.
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pa je John sodeloval v poskusnem postopku.
05:19
It is approved under an FDAIDE
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Uporabo postopka v raziskovalne namene
05:22
at the University of Virginia
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je odobril odbor Ministrstva za zdravje
05:24
in Charlottesville
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na virginijski univerzi v Charlottesvillu,
05:26
using focused ultrasound
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in tako smo z usmerjenim ultrazvokom
05:28
to ablate a point in his thalamus.
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uničili delček tkiva v njegovem talamusu.
05:33
And this is his handwriting.
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To je njegova pisava.
05:36
"On June 20th," if you can read it,
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"Dvajsetega junija," če lahko preberete,
05:39
"2011."
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"leta 2011".
05:42
This is his handwriting
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To je njegova pisava
05:44
on the morning of the treatment
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na jutro posega,
05:46
before going into the MR
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pred vstopom v prostor za MRI.
05:48
So now I'll take you through
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Pokazal vam bom,
05:50
[what] a typical procedure like that looks like,
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kako deluje tak tipičen postopek
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[what] noninvasive surgery looks like.
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oz. neinvazivni kirurški poseg.
05:56
So we put the patient on the MR table.
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Pacient leži na mizi za slikanje z magnetno resonanco.
05:59
We attach a transducer, in this case, to the brain,
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V tem primeru prevodnik usmerimo na možgane,
06:01
but if it will be a different organ,
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če pa bi šlo za drug organ,
06:03
it will be a different transducer attached to the patient.
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bi uporabili tudi drugačen prevodnik.
06:07
And the physician
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Zdravnik nato opravi
06:09
will then take a regular MR scan.
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običajno slikanje z magnetno resonanco.
06:12
And the objective of that?
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Kaj je cilj tega?
06:14
I don't have a pointer here,
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Ne morem pokazati na sliko,
06:16
but you see the green, sort of rectangle or trapezoid?
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a vseeno lahko vidite zelen trapezoidni okvir.
06:21
This is the sort of general area of the treatment.
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To je nekakšno splošno območje posega.
06:23
It's a safety boundary
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Predstavlja varnostno mejo
06:25
around the target.
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okrog točke, ki jo ciljamo.
06:27
It's a target in the thalamus.
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Ta točka je v talamusu.
06:29
So once those pictures are acquired
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Ko te slike pridobimo
06:31
and the physician has drawn
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in ko zdravnik označi
06:34
all the necessary safety limits and so on,
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vse potrebne varnostne meje,
06:37
he selects basically a point --
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izbere določeno točko --
06:39
you see the round point in the middle where the cursor is --
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okroglo točko v sredini, ki jo označuje puščica --
06:42
and he presses this blue button called "sonicate."
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in pritisne na modro tipko "Soniciraj".
06:45
We call this instance of injecting the energy,
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Ta način injiciranja energije
06:48
we call it sonication.
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imenujemo ultrazvočna sonikacija.
06:50
The only handwork the physician does here
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Edino delo zdravnikovih rok
06:53
is moving a mouse.
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je pri tem premikanje miške.
06:55
This is the only device he needs in this treatment.
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To je edina naprava, s katero upravlja.
06:58
So he presses "sonicate," and this is what happens.
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Ko pritisne "Soniciraj", se zgodi sledeče.
07:01
You see the transducer, the light blue.
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Prevodnik je svetlo modre barve.
07:03
There's water in between the skull and the transducer.
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Med njim in lobanjo je voda.
07:06
And it does this burst of energy.
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Ustvari se izbruh energije,
07:08
It elevates the temperature.
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s čimer temperatura naraste.
07:10
We first need to verify
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Najprej se moramo prepričati,
07:12
that we are on target.
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da imamo pravo točko.
07:14
So the first sonication
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Prva sonikacija
07:16
is at lower energy.
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poteka z nižjo energijo.
07:18
It doesn't do any damage,
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Ne povzroči nobene škode,
07:20
but it elevates the temperature
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pač pa dvigne temperaturo
07:22
by a few degrees.
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za nekaj stopinj.
07:24
And one of the unique capabilities
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Ena od enkratnih sposobnosti,
07:26
that we leverage with the MR
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ki jih dosežemo z magnetno resonanco,
07:28
is the ability to measure temperature noninvasively.
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je neinvazivno merjenje temperature.
07:32
This is really a unique capability of the MR.
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To je enkratna sposobnost magnetne resonance,
07:35
It is not being used
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ki pa se ne uporablja
07:37
in regular diagnostic imaging.
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pri običajnem diagnostičnem slikanju.
07:39
But here we can get
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V našem primeru pa pridobimo anatomsko sliko
07:41
both the anatomical imaging and the temperature maps in real time.
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in temperaturni profil v danem trenutku.
07:44
And you can see the points there on the graph.
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Na grafu lahko vidite točke.
07:47
The temperature was raised
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Temperatura se je dvignila
07:49
to 43 degrees C temporarily.
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na začasnih 43°C.
07:51
This doesn't cause any damage.
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To ne povzroči nobene škode.
07:53
But the point is we are right on target.
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Pomembno pa je, da ciljamo na pravo točko.
07:55
So once the physician verifies
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Ko torej zdravnik potrdi,
07:58
that the focus spot is on the target he has chosen,
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da je točka fokusiranja prava,
08:01
then we move to perform
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se izvede
08:04
a full-energy ablation
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uničenje delčka tkiva s polno močjo,
08:06
like you see here.
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kot vidite tu.
08:08
And you see the temperature rises
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Temperatura se povzpne
08:11
to like 55 to 60 degrees C.
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med 55 in 60 stopinj Celzija.
08:13
If you do it for more than a second,
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Če to traja več kot eno sekundo,
08:15
it's enough to basically destroy
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je jakost dovolj močna, da uniči
08:18
the proteins of the cells.
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celične beljakovine.
08:22
This is the outcome from a patient perspective --
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In to je rezultat s pacientovega stališča
08:24
same day after the treatment.
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še isti dan po posegu.
08:27
This is an immediate relief.
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Gre za takojšnje izboljšanje.
08:29
(Applause)
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(Aplavz)
08:34
Thank you.
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Hvala.
08:36
John is one of [about] a dozen
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John je en od okrog ducata
08:39
very heroic, courageous people
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zelo pogumnih, herojskih ljudi,
08:43
who volunteered for the study.
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ki so se javili za sodelovanje v raziskavi.
08:45
And you have to understand
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Treba je razumeti,
08:47
what is in people's mind
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o čem razmišljajo ljudje,
08:49
when they are willing to take the risk.
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ki se odločijo tvegati.
08:52
And this is a quote from John after he wrote it.
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John je, potem ko je znova napisal sporočilo,
08:55
He said, "Miraculous."
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dejal, "Neverjetno."
08:57
And his wife said, "This is the happiest moment of my life."
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Njegova žena je rekla, "To je najsrečnejši trenutek mojega življenja."
09:01
And you wonder why.
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Vprašate se, zakaj.
09:03
I mean, one of the messages I like to carry over
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Eno od sporočil, ki ga želim posredovati,
09:06
is, what about defending quality of life?
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je pomen ohranjanja kakovosti življenja.
09:09
I mean, those people lose their independence.
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Ti ljudje so namreč izgubili svojo samostojnost.
09:11
They are dependent on others.
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Odvisni so od pomoči drugih.
09:13
And John today is fully independent.
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John pa je danes v celoti samostojen
09:16
He returned to a normal life routine.
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in nadaljuje z vsakodnevno rutino.
09:19
And he also plays golf,
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Igra tudi golf,
09:21
like you do in Virginia
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kot običajno počnejo
09:23
when you are retired.
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upokojeni v Virginiji.
09:28
Okay, so you can see here the spot.
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Tu lahko vidite točko.
09:32
It's like three millimeters in the middle of the brain.
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Meri približno tri milimetre v središču možganov.
09:34
There's no damage outside.
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Okrog nje ni poškodb.
09:36
He suffers from no neurodeficit.
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Ni več okvar živčevja.
09:39
There's no recovery needed, no nothing.
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Po posegu ne potrebuje niti okrevanja,
09:42
He's back to his normal life.
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pač pa se vrne v običajno življenje.
09:44
Let's move now
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Poglejmo si sedaj
09:46
to a more painful subject.
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bolj občutljivo področje.
09:48
Pain is something
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Bolečina je nekaj,
09:50
that can make your life miserable.
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kar vam lahko zagreni življenje.
09:52
And people are suffering from all kinds of pain
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Ljudje trpijo zaradi vseh vrst bolečine,
09:54
like neuropathic pain, lower-back pain
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od nevropatske bolečine, bolečine v križu,
09:58
and cancer pain from bone metastases,
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do onkološke bolečine
10:01
when the metastases get to your bones,
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metastaz na kosteh,
10:04
sometimes they are very painful.
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kjer lahko postanejo izjemno boleče.
10:07
All those I've indicated
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Vsi ti tipi bolečin
10:09
have already been shown
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so bili dokazano
10:11
to be successfully treated
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uspešno zdravljeni
10:13
by focused ultrasound
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z usmerjenim ultrazvokom,
10:16
relieving the pain, again, very fast.
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ki je zelo hitro odpravil bolečino.
10:19
And I would like to tell you
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Rad bi vam predstavil še
10:21
about PJ.
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PJ-jev primer.
10:25
He's a 78 year-old farmer
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PJ je 78-letni kmet,
10:29
who suffered from -- how should I say it? --
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ki je imel -- kako naj to povem? --
10:32
it's called pain in the butt.
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bolečino v zadnjici.
10:34
He had metastases in his right buttock,
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Imel je metastaze na desni strani,
10:37
and he couldn't sit
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zaradi česar ni mogel sedeti
10:39
even with medication.
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niti ob uporabi zdravil.
10:41
He had to forgo all the farm activities.
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Moral se je odpovedati vsem dejavnostim na kmetiji.
10:48
He was treated with radiation therapy,
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Zdravili so ga z obsevanjem,
10:50
state-of-the-art radiation therapy,
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najsodobnejšim obsevanjem,
10:52
but it didn't help.
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a mu ni pomagalo.
10:54
Many patients like that favor radiation therapy.
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Veliko takih pacientov se odloči za obsevanje.
10:57
And again, he volunteered
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Tudi on je prostovoljno sodeloval
10:59
to a pivotal study
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v osrednji raziskavi,
11:01
that we ran worldwide,
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ki je potekala po celem svetu,
11:04
also in the U.S.
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tudi v ZDA.
11:08
And his wife actually took him.
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Pripeljala ga je njegova žena.
11:11
They drove like three hours
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Od kmetije do bolnišnice
11:13
from their farm to the hospital.
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sta se vozila tri ure.
11:16
He had to sit on a cushion,
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Moral je sedeti na blazini
11:19
stand still, not move,
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in se ne premikati,
11:21
because it was very painful.
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saj je bilo preveč boleče.
11:24
He took the treatment,
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Po posegu
11:26
and on the way back,
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je na poti na kmetijo
11:29
he drove the truck by himself.
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sam vozil tovornjak.
11:33
So again, this is an immediate relief.
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Še enkrat gre torej za takojšnje izboljšanje.
11:36
And you have to understand
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Treba je upoštevati,
11:38
what those people feel
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kako se ti ljudje počutijo
11:40
and what their family experiences
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in kaj občutijo njihove družine,
11:43
when it happens.
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ko poseg uspe.
11:45
He returned again
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PJ se je vrnil
11:47
to his daily routine on the farm.
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k svoji dnevni rutini na kmetiji.
11:49
He rides his tractor.
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Sam vozi traktor,
11:51
He rides his horse to their mountain cabin regularly.
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pogosto celo jaha na konju do svoje koče v hribih.
11:55
And he has been very happy.
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Res je srečen.
11:58
But now, you ask me,
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Sedaj pa vas zanima,
12:01
but what about war, the war on cancer?
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ali lahko s tem napovemo vojno raku?
12:03
Show us some primary cancer.
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Kaj lahko storimo
12:06
What can be done there?
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v začetnem stadiju rakavih obolenj?
12:08
So I have good news and bad news.
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Imam dobro in slabo novico.
12:10
The good news: there's a lot that can be done.
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Dobra je, da se lahko stori marsikaj.
12:13
And it has been shown actually outside of the U.S.
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To smo dokazali izven ZDA.
12:16
And doing that in the U.S.
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V ZDA je namreč take posege
12:20
is very painful.
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zelo težko opravljati.
12:22
I don't see, without this nation
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Bojim se, da če ne bo ta narod
12:26
taking it as some collective will
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tega sprejel kot skupno željo
12:30
or something that is a national goal to make that happen,
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ali kot cilj celega naroda, da bi to omogočil,
12:33
it will not happen.
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bodo taki posegi nemogoči.
12:35
And it's not just because of regulation;
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Razlog niso samo predpisi,
12:37
it's because of the amount of money needed
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pač pa predvsem količina denarja, zahtevana
12:40
under the current evidence-based medicine
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v današnjem zdravstvu, ki temelji na dokazih,
12:44
and the size of trials and so on
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in za obsežne raziskave,
12:46
to make it happen.
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ki to onemogoča.
12:48
So the first two applications
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Najprej smo ta način uporabili
12:50
are breast cancer and prostate cancer.
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pri raku dojk in raku prostate.
12:53
They were the first to be treated by focused ultrasound.
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Na teh dveh vrstah raka smo najprej izvedli postopek.
12:56
And we have better-than-surgery results in breasts.
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Pri raku dojk so rezultati boljši kot pri operaciji.
13:01
But I have a message for the men here.
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Imam pa tudi sporočilo za moške.
13:03
We heard here yesterday Quyen
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Včeraj je tu Quyen govorila o
13:06
talking about the adverse event trait
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neželenih dogodkih
13:09
in prostate cancer.
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pri raku prostate.
13:11
There is a unique opportunity now
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Tu imamo izjemno priložnost uporabe
13:13
with focused ultrasound guided by MR,
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usmerjenega ultrazvoka, ki ga vodi MR,
13:16
because we can actually think about
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saj si dejansko lahko zamislimo
13:19
prostate lumpectomy --
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lumpektomijo prostate, s čimer bi
13:21
treating just the focal lesion
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zdravili le glavno poškodbo
13:23
and not removing the whole gland,
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brez ostranitve celotne žleze
13:25
and by that, avoiding all the issues
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in se tako izognili vsem težavam
13:28
with potency and incontinence.
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s potenco in inkontinenco.
13:32
Well, there are other cancer tumors in the abdomen --
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Tu imamo še druge rakave tumorje v trebuhu,
13:38
quite lethal, very lethal actually --
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ki jih je pravzaprav zelo malo --
13:40
pancreas, liver, kidney.
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rak na trebušni slinavki, jetrih in ledvicah.
13:43
The challenge there
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Izziv pri tem je --
13:45
with a breathing and awake patient --
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ob pacientu, ki diha in je buden,
13:48
and in all our treatments,
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in tako kot pri vseh
13:50
the patient is awake and conscious
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naših posegih zavestno
13:52
and speaks with the physician --
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govori z zdravnikom --
13:56
is you have to teach the MR some tricks
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da naučimo napravo za magnetno resonanco,
13:59
how to do it in real time.
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kako naj poseg izvede ob pravem času.
14:02
And this will take time.
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To pa bo terjalo čas.
14:04
This will take two years.
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Trajalo bo približno dve leti.
14:06
But I have now a message to the ladies.
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Imam pa tudi sporočilo za dame.
14:09
And this is, in 2004,
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Leta 2004 je Ministrstvo za zdravje odobrilo uporabo
14:12
the FDA has approved MR-guided focused ultrasounds
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usmerjenega ultrazvoka z magnetno resonanco
14:15
for the treatment of symptomatic uterine fibroids.
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za zdravljenje simptomatskih materničnih fibroidov.
14:20
Women suffer from that disease.
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Ženske zbolijo za to boleznijo.
14:24
All those tumors
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Za te tumorje je značilno
14:26
have heavy bleeding during periods,
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močno krvavenje v času perila,
14:28
abdominal pressure, back pain,
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hude bolečine v trebuhu in hrbtu
14:30
frequent urination.
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ter pogosto uriniranje.
14:32
And sometimes, they cannot even conceive and become pregnant
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Včasih celo ne morejo spočeti otroka in zanositi
14:36
because of the fibroid.
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zaradi fibroidov.
14:38
This is Frances.
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To je Frances.
14:40
She was diagnosed with a grapefruit-sized fibroid.
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Odkrili so ji fibroid v velikosti grenivke.
14:42
This is a big fibroid.
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Gre za velik fibroid.
14:44
She was offered a hysterectomy,
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Ponudili so ji histerektomijo,
14:46
but this is an inconceivable proposition
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kar pa je nesprejemljiv predlog
14:48
for someone who wants to keep her pregnancy option.
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za nekoga, ki želi nekoč zanositi.
14:51
So she elected to undergo a focused ultrasound procedure
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Zato se je leta 2008 odločila za poseg
14:55
in 2008.
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z usmerjenim ultrazvokom.
14:57
And in 2010, she became a first-time mother to a healthy baby.
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Leta 2010 je postala mlada mamica zdravi dojenčici.
15:01
So new life was born.
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Rodilo se je novo življenje.
15:03
(Applause)
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(Aplavz)
15:05
So in conclusion,
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Za konec imam za vas
15:08
I'd like to leave you with actually four messages.
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štiri sporočila.
15:11
One is, think about the amount
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Prvič, pomislite,
15:13
of suffering that is saved
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koliko trpljenja prihranimo pacientom
15:15
from patients undergoing noninvasive surgery,
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v postopku neinvazivnega posega,
15:19
and also the economical and emotional burden
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in koliko finančnega in čustvenega bremena
15:23
removed from their families and communities
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prihranimo njihovim družinam, skupnostim
15:26
and the society at large --
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in družbi nasploh
15:30
and I think also from their physicians, by the way.
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ter nenazadnje tudi njihovim zdravnikom.
15:36
And the other thing I would like you to think about
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Drugič, rad bi, da razmislite
15:39
is the new type of relationship
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o novi vrsti odnosa
15:42
between physician and patients
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med zdravniki in pacienti,
15:44
when you have a patient on the table
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ko je pacient na mizi buden
15:47
[who] is awake and can even monitor the treatment.
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in preko zaslona spremlja poseg.
15:50
In all our treatments,
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Pri vseh naših posegih ima pacient
15:52
the patient holds a stop sonication button.
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dostop do gumba, ki ustavi sonikacijo.
15:54
He can stop the surgery at any moment.
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Poseg lahko prepreči, kadar želi.
15:58
And with that note,
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S to mislijo
16:01
I would like to thank you for listening.
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se vam zahvaljujem za pozornost.
16:04
(Applause)
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(Aplavz)
ABOUT THE SPEAKER
Yoav Medan - Medical inventorWith his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound.
Why you should listen
Yoav Medan is the Chief Systems Architect at InSightec Ltd. in Israel, where he works on MRI-guided guided focused ultrasound technology. Before this, he spent 17 years in research and management at the IBM Research Division and was elected to the IBM Academy of Technology. Medan has taught at the EE department at the Technion, Israel Institute of Technology, in addition to serving as a lecturer for Avionic Systems at the Aeronautical Engineering faculty, and mentors young enterpreneurs as part of the Technion Alumni "Technion for Life" program. He plans a 2012 sabbatical as an associate professor at the BioMedical Engineering department of the Technion and its Autonomous Systems Program.
Medan is also the inventor of the QR-code enabled tombstone. Read Adam Ostrow's Q&A with Yoav Medan at TEDGlobal >>
Yoav Medan | Speaker | TED.com