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