OPERATING THEATRE TECHNOLOGY
to identify likely advances in medicine and technology in the next 20 years, singled out four main areas: n Minimally invasive surgery and robots. n Imaging, virtual reality, augmented reality, and 3D printing.
n ‘Big data’, genomics, and artificial intelligence.
n Specialist interventions, such as printing of tissue or organs, and nanosurgery. Open platform operating theatre control
systems should include the necessary interfaces for the harnessing of ‘big data’ and the Internet of Things (IoT), to address each of these four identified areas and many more, and play a major role in publishing and subscribing to a democratised and limitless knowledge base for improvements across all medical fields, not just surgery.
Technologies with the power to disrupt theatre practice / design? Surgery 4.0 is made possible by the Internet of Things, the interconnection via the Internet of IP-addressed devices, together with video over IP, big data, cognitive computing, and artificial intelligence. To do all of these wonderful things – to gather and store information and data, move it around at speed, process it, analyse it, machine-learn from it, repackage it, and send it to some action point - requires a lot of transmission and processing power. Technologies set to have the biggest impact will be those like 5G, the latest and fastest wireless communication system that will overcome current physical infrastructural limitations in transporting large amounts of data and cloud-based storage and processing solutions from companies like AWS, Azure, Google, and Alibaba. New technologies such as blockchain, quantum computers, and the underlying principles of machine learning, will combine to create a cyber-world that demonstrates real intelligence, with unparalleled abilities in problem-solving. In addition, there is edge computing: the decentralisation of processing power to pre-process or
In a connected OR, each device that has data to share can share – either with onsite or cloud-based applications for AI, VR, and AR etc, ‘turning data into insights and guidance for better outcomes and future learning’.
completely process data at source before sending or publishing.
Distributed, unlimited, and unbreakable Processing power and storage should be distributed, unlimited, and unbreakable, with redundancy built in. This is in stark contrast to the current norm, where machines effectively learn everything for the first time, again and again, and where the inefficient duplication, storage, and processing of that data is local. To meet the requirements of Surgery
4.0, we need the convergence of all signal and data types to the IP standard, and so any new technology that promotes this convergence, and provides the processing power, storage, and low latency transfer of secure and encrypted data streams, will empower Surgery 4.0 and so much more.
How will Surgery 4.0 improve surgery? While future autonomous surgical robots
might well represent Surgery 5.0, for now I believe we should rather focus on augmenting our current human surgeons, and robots today do exactly that. However, if we could connect the surgeons and the machines to data-gathering services, we could democratise their combined knowledge. In some ways, this digital human augmentation could be seen as a vital step in actually providing the knowledge that the machines of the future will need to create an unbreakable, incomparably powerful, collaborative support system. Once we open up the data doors to operating rooms, we can take advantage of these underlying technologies of cheaper offsite storage and the power of computing. We already have the ability to upload scans to cloud-based 3D modelling laboratories. The importance of these services will only increase, and in some specialities – such as paediatric urology – 3D surgical planning is widely considered to be mandatory in order to perform safe and effective surgery.
September 2022 Health Estate Journal 59
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