A universal translator for surgeons Steven Schwaitzberg

so I want to talk to you about two

things tonight number one teaching

surgery and doing surgery is really hard

and second that language is one of the

most profound things that separate us

all over the world and in my little

corner of the world these two things are

actually related I want to tell you how

tonight now nobody wants an operation

who here has had surgery did you want it

keep your hands up if you wanted an

operation nobody wants an operation in

particular nobody wants an operation

with tools like these through large

incisions that cause a lot of pain that

caused a lot of time out of work or out

of school that leave a big scar but if

you have to have an operation what you

really want is a minimally invasive

operation that’s what I want to talk to

you about tonight how doing and teaching

this type of surgery led us on a search

for a better universal translator now

this type of surgery is hard and it

starts by putting people to sleep

putting carbon dioxide in their abdomen

blowing them up like a balloon sticking

one of these sharp pointy things into

their abdomen dangerous stuff and taking

instruments and watching it on a TV

screen so let’s see what it looks like

so this is gallbladder surgery we

perform a million of these a year in the

united states alone this is the real

thing there’s no blood and you can see

how focused the surgeons are how much

concentration it takes you can see it in

their faces it’s hard to teach and it’s

not all that easy to learn we do about

five million of these in the United

States and maybe 20 million of these

worldwide all right you’ve all heard the

term he’s a born surgeon let me tell ya

surgeons are not born surgeons are not

made either you know little tanks where

we’re making surgeons surgeons are

trained one step at a time it starts

with a foundation basic skills we build

on that and we take people hopefully to

the operating room where they learn to

be an assistant then we teach them to be

a surgeon in training and when they do

all of that for about five years they

get the coveted board certification if

you need surgery you want to be operated

on by a board-certified surgeon you get

your board certificate and you can go

out into practice and eventually if

you’re lucky you achieve mastery now

that foundation is so important that a

number of us from the largest general

surgery Society of the United States

sages started in the late 1990s a

training program that would assure that

every surgeon who practices minimally

invasive surgery would have a strong

foundation of knowledge and skills

necessary to go on and do procedures now

the science behind this is so potent

that it became required by the American

Board of surgery in order for a young

surgeon to become board certified it’s

not a lecture it’s not a course it’s all

of that plus a high-stakes assessment

it’s hard now just this past year one of

our partners the American College of

Surgeons teamed up with us to make an

announcement that all surgeons should be

fls certified before they do minimally

invasive surgery and are we talking

about just people here in the US and

Canada no we just said all surgeons so

to lift this education and training

worldwide is a very large task something

I’m very personally excited about as we

travel around the world sages does

surgery all over the world teaching and

educating surgeons so we have a problem

and one of the problems is distance we

can’t travel every

we need to make the world a smaller

place and I think that we can develop

some tools to do so and one of the tools

I like personally is using video so I

was inspired by a friend this is Alan a

chronic from Toronto and he proved that

you could actually teach people to do

surgery using video conferencing so

here’s Allen teaching an

english-speaking surgeon in Africa these

basic fundamental skills necessary to do

minimally invasive surgery very

inspiring but for this examination which

is really hard we have a problem even

people who say they speak english only

fourteen percent pass because for them

it’s not a surgery test it’s an English

test let me bring it to you locally I

work at the Cambridge hospital it’s a

primary Harvard Medical School teaching

facility we have more than a hundred

translators covering 63 languages and we

spend millions of dollars just in our

little Hospital it’s a big labor

intensive effort if you think about the

worldwide burden of trying to talk to

your patients not just teaching surgeons

just trying to talk to your patients

there aren’t enough translators in the

world we need to employ technology to

assist us in this quest at our hospital

we see everybody from Harvard professors

to people who just got here last week

and you have no idea how hard it is to

talk to somebody or take care of

somebody you can’t talk to and there

isn’t always a translator available so

we need tools we need a universal

translator one of the things that I want

to leave you with as you think about

this talk is that this talk is not just

about us preaching to the world it’s

really about setting up a dialogue we

have a lot to learn here in the United

States we spend more money per person

for outcomes that are not better than

many countries in the

world maybe we have something to learn

as well so I’m passionate about teaching

these fls skills all over the world this

past year I’ve been in Latin America

I’ve been in China talking about

fundamentals of laparoscopic surgery and

everywhere I go the barrier is we want

this but we need it in our language so

here’s what we think we want to do

imagine giving a lecture and being able

to talk to people in their own native

language simultaneously I want to talk

to the people in Asia Latin America

Africa Europe seamlessly accurately and

in the cost effective fashion using

technology and it has to be

bi-directional they have to be able to

teach us something as well it’s a big

task so we looked for a universal

translator I thought there would be one

out there your web page has translation

your cell phone has translation but

nothing that’s good enough to teach

surgery because we need a lexicon what

is the lexicon a lexicon is a body of

words that describes a domain I need to

have a health care lexicon and in that I

need a surgery lexicon that’s a tall

order we have to work at it so let me

show you what we’re doing this is

research can’t buy it we’re working with

the folks at IBM research from the

accessibility Center to string together

technologies to work towards the

universal translator it starts with a

framework system where with a surgeon

delivers the lecture using a framework

of captioning technology we then add

another technology to do video

conferencing but we don’t have the words

yet so we add a third technology and now

we’ve got the words and we can apply the

special sauce the translation we get the

words up in a window and then apply the

magic the work at the fourth technology

and we’re currently have access to 11

language pairs more to come as we

about trying to make the world a smaller

place I’d like to show you our prototype

of stringing all of these technologies

that don’t necessarily always talk to

each other to become something useful

fundamentals of laparoscopic surgery

module 5 manual skills practice students

may display captions in their native

language if you’re in Latin America you

click I want it in Spanish button and

alpha comes in real time in Spanish but

if you happen to be sitting in Beijing

at the same time by using technology in

a constructive fashion you could get it

in Mandarin or you could get it in

Russian on and on and on simultaneously

without the use of human translators but

that’s the lectures if you remember what

I told you about fls at the beginning

its knowledge and skills the difference

in an operation between doing something

successfully and not maybe moving your

hand this much so we’re going to take it

one step further we brought my friend

Alan back today we’re going to practice

suturing this is how you hold the needle

grab the needle at the tip

it’s important to be accurate aim for

the black dots or en to your loop this

way now go ahead and cut very good Oscar

I’ll see you next week so that’s what

we’re working on and our quest for the

universal translator we want it to be

bi-directional we have a need to learn

as well as to teach I can think of that

million uses for a tool like this as we

think about introduce ecting

technologies everybody has a cell phone

with a camera we could use this

everywhere whether it be health care

patient care engineering law

conferencing translating videos this is

ubiquitous tool in order to break down

our barriers we have to learn to talk to

people to demand that people work on

translation we need it for our everyday

life in order to make the world a

smaller place thank you very much

you