TEDWomen 2017
Nadine Hachach-Haram: How augmented reality could change the future of surgery
Nadine Hachach-Haram: 增强现实如何改变手术界的未来
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一个人如果需要做手术，无论那些手术团队距离他有多远，患者肯定都希望得到最好的团队去进行。作为一名外科医生和企业家，Nadine Hachach-Haram正在发明一个可以在不同地方使用，并且可以使医生们互相帮助并学习新技术的低成本系统——增强现实仪器。而她在新奥尔良洲的TED舞台上通过直播与另一名外科医生的一场膝部手术，从而来展现这个全新系统的运作方式。就如Hachach-Haram所说："即使是我们生活中平淡无奇的设备，也能帮助我们创造奇迹"。（这场演讲包含手术有关的画面。）
Nadine Hachach-Haram - Surgeon, entrepreneur
The co-founder of Proximie, Nadine Hachach-Haram is a curious surgeon with a passion for technology and innovation -- and a desire to make a difference in the world. Full bio
The co-founder of Proximie, Nadine Hachach-Haram is a curious surgeon with a passion for technology and innovation -- and a desire to make a difference in the world. Full bio
Double-click the English transcript below to play the video.
00:12
According to the theories
of human social development,
of human social development,
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根据人类社会发展的理论，
00:15
we're now living
through the fourth great epoch
through the fourth great epoch
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我们目前正在经历着科技进展的
00:17
of technological advancement,
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第四时期，
00:20
the Information Age.
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信息时代
00:22
Connectivity through digital technology
is a modern miracle.
is a modern miracle.
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由数字科技所提供的连接性是一个现代奇迹
00:25
We can say it has broken down barriers
of time and space which separate people,
of time and space which separate people,
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这种连接打破了人们之间的时间与空间屏障，
00:31
and it's created a condition for an age
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并且创造了一个
00:32
where information, ideas
can be shared freely.
can be shared freely.
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可以自由分享信息和想法的时代
00:37
But are these great accomplishments
in digital technology
in digital technology
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但是数字科技带来的伟大成就
00:40
really the endgame
in terms of what can be achieved?
in terms of what can be achieved?
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真的就仅此而已了吗？
00:43
I don't think so,
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我并不这么认为，
00:45
and today I'd like to share with you
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今天我想跟大家分享一下
00:46
how I believe digital technology
can take us to even greater heights.
can take us to even greater heights.
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我对数字科技未来新高度的展望
00:51
I'm a surgeon by profession,
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我是一名外科医生，
00:53
and as I stand here today
talking to all of you,
talking to all of you,
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在我站在这里跟你们讲话的同时，
00:56
five billion people around the world
lack access to safe surgical care.
lack access to safe surgical care.
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全球各地有五十亿的人缺少安全的手术护理
01:00
Five billion people.
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五十亿人
01:03
That's 70 percent
of the world's population,
of the world's population,
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占了有全球70%的人口，
01:05
who according to the WHO's
Lancet Commission
Lancet Commission
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根据世界卫生组织“柳叶刀委员会”的标准，
01:08
can't even access
simple surgical procedures
simple surgical procedures
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他们甚至连最基本的外科手术
01:11
as and when they need them.
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都进行不了
01:13
Let's zoom in on Sierra Leone,
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让我们看看塞拉利昂，
01:15
a country of six million people,
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这是一个六百万人口的国家，
01:18
where a recent study showed
that there are only 10 qualified surgeons.
that there are only 10 qualified surgeons.
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一项近期的研究指出那里只有十名合格的外科医生
01:22
That's one surgeon
for every 600,000 people.
for every 600,000 people.
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那就是六十万人民指望着一名医生
01:26
The numbers are staggering,
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数字很惊人，
01:28
and we don't even need to look that far.
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我们甚至不用看得那么远
01:31
If we look around us here in the US,
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如果我们关注一下美国，
01:33
a recent study reported that we need
an extra 100,000 surgeons by 2030
an extra 100,000 surgeons by 2030
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一项研究报告说在2030年前
我们需要额外的十万名外科医生
我们需要额外的十万名外科医生
01:38
to just keep up with the demand
for routine surgical procedures.
for routine surgical procedures.
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仅仅来应对日常的外科手术需求
01:42
At the rate that we're going,
we won't be meeting those numbers.
we won't be meeting those numbers.
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而依照我们现在的发展速度
这十万是达不到的
这十万是达不到的
01:47
As a surgeon, this is
a global issue that bothers me.
a global issue that bothers me.
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作为一名外科医生
这个全球性的问题很是困扰着我
这个全球性的问题很是困扰着我
01:50
It bothers me a lot,
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使我心烦意躁，
01:51
because I've seen firsthand
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因为我亲身经历过，
01:53
how lack of access
to safe and affordable healthcare
to safe and affordable healthcare
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如果接收不到安全的承担得起的护理
01:56
can blight the lives of ordinary people.
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老百姓的生活将会深深的受到伤害
01:58
If you're a patient
that needs an operation
that needs an operation
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如果你是一名急需进行手术的患者
02:01
and there isn't a surgeon available,
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可是当时并没有空闲的外科医生，
02:02
you're left with some
really difficult choices:
really difficult choices:
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你只有这几项艰难选择：
02:05
to wait, to travel,
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等待，另寻他路，
02:09
or not to have an operation at all.
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或者放弃治疗
02:12
So what's the answer?
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所以，怎么解决呢？
02:15
Well, part of you are carrying
some of that solution with you today:
some of that solution with you today:
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其实，今日在座的各位就携带着一部分：
02:19
a smartphone, a tablet, a computer.
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一部智能手机，一个平板电脑或者一台电脑
02:23
Because for me,
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因为对我而言，
02:24
digital communications technology
has the power to do so much more
has the power to do so much more
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数字通信技术拥有更强大的威力
02:28
than just to allow us to shop online,
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不仅仅能让我们网络购物，
02:30
to connect through social media platforms
and to stay up to date.
and to stay up to date.
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与朋友们在社交媒体中聊天，跟上潮流
02:34
It has the power to help us solve
some of the key issues that we face,
some of the key issues that we face,
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它还可以解决我们面临的一些关键问题，
02:39
like lack of access
to vital surgical services.
to vital surgical services.
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比如难以接受到关键手术
02:42
And today I'd like to share with you
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今天我想跟大家分享一下
02:44
an example of how I think
we can make that possible.
we can make that possible.
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我对如何实现这个问题的想法
02:47
The history of surgery
is filled with breakthroughs
is filled with breakthroughs
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手术的历史充满着科学和技术上的突破，
02:49
in how science and technology
was able to help the surgeons of the day
was able to help the surgeons of the day
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这些突破帮助如今的外科医生，
02:53
face their greatest challenges.
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面临严峻的挑战
02:54
If we go back several hundred years,
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我们如果回到几百年前，
02:56
an understanding of microbiology
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当时微生物学的发现
02:58
led to the development
of antiseptic techniques,
of antiseptic techniques,
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带来了杀菌技术的发展，
03:00
which played a big role in making sure
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这项技术大大提高了
03:02
patients were able
to stay alive postsurgery.
to stay alive postsurgery.
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病人术后的存活率
03:05
Fast-forward a few hundred years
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往后快进个几百年，
03:06
and we developed
keyhole or arthroscopic surgery,
keyhole or arthroscopic surgery,
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我们发明了“微创”手术
也就是关节镜手术，
也就是关节镜手术，
03:09
which combines video technology
and precision instruments
and precision instruments
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这种技术结合了视频技术和高精密仪器
03:12
to make surgery less invasive.
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减少了手术产生的创伤
03:15
And more recently, a lot of you
will be aware of robotic surgery,
will be aware of robotic surgery,
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就在不远的将来
机器人手术将来到我们身边，
机器人手术将来到我们身边，
03:19
and what robotics brings to surgery
is much like modern automated machinery,
is much like modern automated machinery,
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而这种技术就像现代的机械技术一样，
03:23
ultraprecision,
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超级精密，
03:25
the ability to carry out procedures
at the tiniest scales
at the tiniest scales
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它可以在最细小的程度上进行手术
03:29
with a degree of accuracy
that even surpasses the human hand.
that even surpasses the human hand.
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如此程度甚至超过了人手的精度
03:34
But robotic surgery also introduced
something else to surgery:
something else to surgery:
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机器人手术还给手术带来一种新的想法：
03:38
the idea that a surgeon
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一名外科医生，
03:39
doesn't actually have to be standing
at the patient's bedside to deliver care,
at the patient's bedside to deliver care,
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并不需要亲身站在患者面前进行手术
03:44
that he could be looking at a screen
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他可以看着屏幕
03:46
and instructing a robot
through a computer.
through a computer.
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使用电脑操控着机器人，
03:49
We call this remote surgery.
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我们称之为“远距外科”
03:54
It is incumbent on us
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我们有义务，
03:56
to find solutions that solve these answers
in a cost-effective and scalable way,
in a cost-effective and scalable way,
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用合算的，可发展的方式解决这些问题，
04:01
so that everyone, no matter
where they are in the world,
where they are in the world,
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实现无论何时何地，
04:03
can have these problems addressed.
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大家都可以得到帮助
04:06
So what if I told you
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如果我告诉你们
04:08
that you didn't really need
a million-dollar robot
a million-dollar robot
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其实并不需要一个百万美元的机器人
04:10
to provide remote surgery?
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来进行远距手术
04:12
That all you needed
was a phone, a tablet, or a computer,
was a phone, a tablet, or a computer,
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你需要的全部
只是一部手机，一个平板电脑或者一台电脑，
只是一部手机，一个平板电脑或者一台电脑，
04:17
an internet connection,
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连接上互联网，
04:19
a confident colleague on the ground
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还有一名有信心的外科医生在线，
04:21
and one magic ingredient:
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再加上一点点魔法：
04:24
an augmented reality
collaboration software.
collaboration software.
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一个增强现实协同软件
04:28
Using this augmented reality
collaboration software,
collaboration software,
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使用这部软件，
04:30
an expert surgeon
can now virtually transport himself
can now virtually transport himself
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一名专业的外科医生可以虚拟的“传输”他自己
04:33
into any clinical setting
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到任何一家诊所
04:35
simply by using his phone
or tablet or computer,
or tablet or computer,
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仅仅通过他的手机，平板或者电脑，
04:38
and he can visually and practically
interact in an operation
interact in an operation
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虚拟的进行一场手术
04:41
from start to finish,
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从头至尾，
04:43
guiding and mentoring a local doctor
through the procedure step by step.
through the procedure step by step.
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引导着现场医生一步步地进行手术
04:47
Well, enough of me telling you about it.
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好啦，我说的已经够多的了
04:50
I'd now like to show you.
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我想给你们展示一下
04:54
We're now going to go live
to Dr. Marc Tompkins,
to Dr. Marc Tompkins,
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我将直播一场由Marc Tompkins大夫，
04:57
an orthopedic surgeon
at the University of Minnesota.
at the University of Minnesota.
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一名明尼苏达大学的矫形外科医师，
05:01
He's going to perform
an arthroscopic surgery for us,
an arthroscopic surgery for us,
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主刀的关节镜手术，
05:04
a keyhole surgery of the knee,
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也就是对于膝盖骨的微创手术
05:06
and I'd like to disclose
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我想声明一下，
05:08
that this patient has consented
to having their operation streamed.
to having their operation streamed.
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这名患者已经准许我们直播这场手术了
05:14
I'd also like to point out
that in the interest of time,
that in the interest of time,
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另外由于时间关系，
05:16
we're just going to go
through the first steps,
through the first steps,
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我们只会观看最开始的部分，
05:18
marking up the patient
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也就是诊断一下患者，
05:20
and just identifying
a few key anatomical landmarks.
a few key anatomical landmarks.
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识别出几处关键的解剖标志
05:24
Hello, Dr. Tompkins, can you hear me?
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您好，Tompkins大夫，您听得见我吗？
05:28
Dr. Mark Tompkins: Good morning, Nadine.
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早安，Nadine
05:30
Nadine Hachach-Haram:
Everyone from TED says hello.
Everyone from TED says hello.
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TED现场的观众请欢迎一下他
05:32
Audience: Hi.
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Hi~
05:36
NHH: Alright, Dr. Tompkins,
let's get started.
let's get started.
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好的Tompkins大夫，让我们开始吧
05:38
So let's start with our incisions
and where we're going to make these,
and where we're going to make these,
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我们先从这些切口开始，
05:41
on either side of the patellar tendon.
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它们的位置在膝盖肌腱的两侧，
05:43
So if you can make
your incisions there and there,
your incisions there and there,
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如果你能在那里和那里开口，
05:47
that should hopefully
get us into the knee.
get us into the knee.
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就能很顺利地到达膝盖
05:51
MT: All right, I'm going in.
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好的，我要开始了
05:53
NHH: Great.
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好的
05:57
So we're just getting
inside the joint now.
inside the joint now.
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我们开始进入这些关节里面去了
06:02
So why don't we go around
and have a quick look at the meniscus.
and have a quick look at the meniscus.
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让我们来快速检查一下“半月板”，
06:07
MT: Perfect.
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没问题
06:11
NHH: Great, so we can see there's
a small tear there on the meniscus,
a small tear there on the meniscus,
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好的，我们可以看到半月板有一点小小的撕裂，
06:15
but otherwise it looks alright.
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其他地方看上去没有问题
06:18
And if you turn
and head to this direction,
and head to this direction,
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如果你朝着这个方向，
06:21
follow my finger,
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顺着我的手指，
06:22
let's have a quick look
at the ACL and the PCL.
at the ACL and the PCL.
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让我们快速检查一下交叉韧带
06:26
That's your ACL there,
that looks quite healthy,
that looks quite healthy,
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看到韧带了，挺健康的，
06:29
no problems there.
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没有问题
06:31
So we've just identified
that small meniscus tear there,
that small meniscus tear there,
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所以我们发现只是“半月板”有一点点撕裂，
06:34
but otherwise the fluid
around the joint looks OK as well.
around the joint looks OK as well.
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其他地方，以及关节旁边的液体都看上去没有问题
06:38
All right, thank you very much,
Dr. Tompkins. Thank you for your time.
Dr. Tompkins. Thank you for your time.
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好的，Tompkins大夫
十分感谢您的时间
十分感谢您的时间
06:42
I'll let you continue.
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我就不打扰您了，请继续
06:43
Have a good day. Bye.
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好运，拜拜
06:46
(Applause)
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（掌声）
06:54
So I hope through
this simple demonstration
this simple demonstration
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我希望通过这一场小小的演示
06:56
I was able to illustrate to you
just how powerful this technology can be.
just how powerful this technology can be.
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可以给你们展现一下这项技术的强大之处
07:00
And I'd like to point out
that I wasn't using any special equipment,
that I wasn't using any special equipment,
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而且我还想指出我并没有使用任何特殊的设备，
07:04
just my laptop and a really simple webcam.
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只有我的笔记本电脑和一个普通的摄像头
07:06
We're so used to using digital technology
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我们都非常习惯使用数字科技
07:08
to communicate through voice
and text and video,
and text and video,
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来进行语音，文字，视频沟通，
07:11
but augmented reality
can do something so much deeper.
can do something so much deeper.
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而增强现实可以做到更多更深
07:15
It allows two people to virtually interact
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它可以让两个人进行虚拟互动，
07:17
in a way that mimics
how they would collaborate in person.
how they would collaborate in person.
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就像他们是在方面合作一样
07:21
Being able to show someone
what you want to do,
what you want to do,
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能够向一个人
07:23
to illustrate and demonstrate and gesture,
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通过说明、演示和手势来传达你的想法，
07:25
is so much more powerful
than just telling them.
than just telling them.
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比仅仅通过语音强大很多
07:28
And it can make
for such a great learning tool,
for such a great learning tool,
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而且这项技术还可以制造很棒的学习工具，
07:31
because we learn better
through direct experience.
through direct experience.
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因为我们在亲身经历中可以更好的学习
07:34
So how is this making
a difference around the world?
a difference around the world?
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所以，它如何改变全世界呢？
07:36
Well, back in my teaching hospital,
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在我的教学医院中，
07:38
we've been using this to support
local district general hospitals
local district general hospitals
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我们已经开始运用这项技术对一些本地的医院
07:41
and providing skin cancer surgery
and trauma treatment.
and trauma treatment.
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提供皮肤癌手术和创伤治疗的帮助
07:44
Now, patients can access
care at a local level.
care at a local level.
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现在病人只要在当地就可以接受治疗，
07:48
This reduces their travel time,
improves their access,
improves their access,
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这减少了他们的交通时间，增加了更多渠道，
07:51
and saves money.
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还很省钱
07:53
We've even started seeing its use
in wound care management with nurses
in wound care management with nurses
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它甚至还可以帮助护士治疗病人伤口，
07:57
and in outpatient management.
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以及对于门诊病人的管理
07:58
Most recently, and quite exciting,
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就在最近，非常令人兴奋，
08:00
it was used in supporting a surgeon
through a cancer removal of a kidney.
through a cancer removal of a kidney.
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这项技术被用来帮助
一名外科医生移除一块癌变的肾脏，
一名外科医生移除一块癌变的肾脏，
08:06
And I'd like to just share with you
a very quick video here.
a very quick video here.
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我想给你们展示一下这个简短的视频
08:09
I apologize for some
of the gruesome views.
of the gruesome views.
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抱歉，它可能包含一些可怕的图像
08:14
(Video) Doctor 1: OK. Show me again.
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（视频）医生1: 好了，让我再看一下
08:17
Doctor 2: If you see here,
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医生2: 你看这里
08:19
that's the upper part,
the most outer part of your tumor.
the most outer part of your tumor.
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这是上部，肿瘤的最外侧
08:23
Doctor 1: Yes.
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医生1: 嗯
08:25
Doctor 2: So it's
three centimeters deep,
three centimeters deep,
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医生2: 它有3厘米深，
08:28
so this should be three centimeters.
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所以这个要调到3厘米
08:30
Doctor 1: Yes, yes.
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医生1: 好的
08:32
Doctor 2: OK,
so you need to get a 3.5 margin.
so you need to get a 3.5 margin.
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医生2: 所以你得切除3.5厘米才可以
08:37
Doctor 1: I'm going to show you anyway
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医生1: 反正我都要给你看，
08:39
and tell me what you think about it.
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跟我说一下你怎么看
08:42
NHH: We're also seeing the use
of this technology at a global scale,
of this technology at a global scale,
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我们在全球都可以看到这项技术的运用，
08:46
and one of the most
heartwarming stories I can recall
heartwarming stories I can recall
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而我可以回想起其中最暖心的故事
08:48
is from the town of Trujillo
in the north of Lima in Peru,
in the north of Lima in Peru,
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是源于秘鲁共和国，利马北部，
特鲁希略市中的一个小镇发生的，
特鲁希略市中的一个小镇发生的，
08:52
where this technology
was used to support the provision
was used to support the provision
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这项技术被用作支持
一项对儿童施展的唇裂和腭裂手术，
08:55
of cleft lip and palate
surgery to children,
surgery to children,
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08:58
children from poor backgrounds who
didn't have access to health insurance.
didn't have access to health insurance.
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这是一个来自贫穷家庭
没有健康保险的孩子
没有健康保险的孩子
09:02
And in this town, there was
a hospital with one surgeon
a hospital with one surgeon
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而这个小镇里的医院只有一名外科医生
09:05
working hard to provide this care,
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努力地提供治疗，
09:06
Dr. Soraya.
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Soraya大夫
09:08
Now, Dr. Soraya was struggling
under the sheer demand
under the sheer demand
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而Soraya大无法应对那么多
来自本地人民的需求，
09:11
of her local population,
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09:12
as well as the fact that she wasn't
specifically trained in this procedure.
specifically trained in this procedure.
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并且她实际上并没有被专门培训过
如何进行这种手术
如何进行这种手术
09:16
And so, with the help of a charity,
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然后，通过基金会的帮助，
09:18
we were able to connect her
with a cleft surgeon in California,
with a cleft surgeon in California,
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我们能够让她与一名加利福尼亚州的
唇腭裂外科医生取得联系，
唇腭裂外科医生取得联系，
09:21
and using this technology, he was able
to guide her and her colleagues
to guide her and her colleagues
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通过这项技术
这名医生指导她和她的同事们
这名医生指导她和她的同事们
09:25
through the procedure step by step,
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一步步地进行手术，
09:26
guiding them, training them
and teaching them.
and teaching them.
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指引，培训并教导他们
09:28
Within a few months,
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几个月以来，
09:30
they were able to perform
30 percent more operations
30 percent more operations
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他们进行的手术多了30%，
09:32
with less and less complications.
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而且并发症也越来越少了
09:34
And now Dr. Soraya and her team
can perform these operations
can perform these operations
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现在，Soraya大夫与她的团队
09:38
independently, competently
and confidently.
and confidently.
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能够自信并独立地完成这些手术
09:42
And I remember one quote
from a mother who said,
from a mother who said,
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我还记得一位母亲曾说过的话：
09:44
"This technology
gave my daughter her smile."
gave my daughter her smile."
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“这项技术给我的女儿带来了微笑”
09:48
For me, this is the real power
of this technology.
of this technology.
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对于我来说
这项技术的威力就是如此
这项技术的威力就是如此
09:51
The beauty is that it breaks boundaries.
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美妙的事，它打破了人们之间的间隔
09:54
It transcends all
technological difficulties.
technological difficulties.
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它可以跨越一切技术困难
09:58
It connects people.
It democratizes access.
It democratizes access.
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它联系着人们
它使访问民主化
它使访问民主化
10:02
Wi-Fi and mobile technology
are growing rapidly,
are growing rapidly,
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无线和移动技术的发展十分迅速，
10:04
and they should play a role
in boosting surgical provision.
in boosting surgical provision.
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而他们应该对手术准确性的提升献出一份力
10:07
We've even seen it used in conflict zones
where there's considerable risk
where there's considerable risk
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这项技术甚至还在一些冲突地区使用，
专业的外科医生去这些地区时会面临很大的危险
10:10
in getting specialist surgeons
to certain locations.
to certain locations.
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10:13
In a world where
there are more mobile devices
there are more mobile devices
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在这样一个
移动设备比人类还多的世界中，
10:16
than there are human beings,
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10:18
it truly has a global reach.
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它真的可以触及全球
10:20
Of course, we've still got a long way
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当然，我们还要走一段很长的路
10:22
before we can solve the problem
of getting surgery to five billion people,
of getting surgery to five billion people,
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在我们能够解决五百万人民的手术问题之前，
10:26
and unfortunately,
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令人不幸的是，
10:27
some people still
don't have access to internet.
don't have access to internet.
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有些人仍然没有互联网连接
10:30
But things are rapidly moving
in the right direction.
in the right direction.
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但是，世界正在向正确的方向快速发展
10:34
The potential for change is there.
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发展的潜力很大
10:36
My team and I are growing
our global footprint,
our global footprint,
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我和我的团队正在全球化发展，
10:39
and we're starting to see
the potential of this technology.
the potential of this technology.
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而我们才刚刚开始认识到这项技术的潜能
10:44
Through digital technology,
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通过数字技术，
10:46
through simple, everyday devices
that we take for granted,
that we take for granted,
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通过我们生活中的普通设备，
10:49
through devices of the future,
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通过未来的设备，
10:51
we can really do miraculous things.
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我们真的可以创造奇迹
10:54
Thank you.
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谢谢大家
10:55
(Applause)
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（掌声）
ABOUT THE SPEAKER
Nadine Hachach-Haram - Surgeon, entrepreneurThe co-founder of Proximie, Nadine Hachach-Haram is a curious surgeon with a passion for technology and innovation -- and a desire to make a difference in the world.
Why you should listen
Dr. Nadine Hachach-Haram is a surgeon, lecturer and clinical entrepreneur. She drew on her passion for innovation, education and global surgery to co-found Proximie, an augmented reality platform that allows doctors to virtually transport themselves into any operating room, anywhere in the world, to visually and practically interact in an operation from start to finish. From marking up a patient to providing real-time virtual presence in assisting and instructing on an operation, Proximie aims to provide safe, accessible and cost-effective surgery to every patient around the world. Dubbed the "future of surgery" by CNN, Proximie has gone from strength to strength and won multiple awards as well as being the main focus of the Foreign Press Association Science Story of the Year. It aims to revolutionize the delivery and education of healthcare by reducing the cost of that delivery while providing improved quality to the end patient, ensuring that every patient gets the best care, the first time, every time.
Nadine Hachach-Haram | Speaker | TED.com