达芬奇:从科幻小说里走来的机器人医生

巍生谈 2018-10-13 11:33:44

嗨,各位,好久不见,这两天巍生(Vicent)在忙着开发一款软件。忽略了大家,不好意思。

好了,废话不多说,精彩的内容给大家呈现。


“天呐,可别让我绊着什么东西。” 

“Oh, God, please don’t let me trip over anything.”

这是我小心翼翼地避过满地的电线走进手术室时的第一个想法。这是十月初的一个早上,我在纽约长岛的犹太医学中心,穿着一件婴儿式的蓝色连体防护服,头发和胡子都被捂得严严实实的,嘴上戴着口罩,鞋外面还戴了一层靴套。 

That’s my first thought as I tiptoe around the electrical cords snaked across the operating room floor. It’s an early October morning at the Long Island Jewish Medical Center in New York. I’m decked out in a onesie-style baby blue protective suit, a hair mat, a bonnet to cover my beard, an additional mask for my mouth, and booties over my shoes.

穿上这些东西,显然不是为了方便,而是为了保护那个躺在离我五尺外的手术台上的病人。他裸露的身体上已经被医生开了几个小洞,那是癌症专家詹姆斯·苏利文医生和他的团队用来插入医疗器械用的。 

None of this is designed for agility. It’s meant to protect the patient lying on the table less than five feet away from me. His exposed torso is peppered with small holes through which cancer surgery specialist Dr. James Sullivan and his team insert their medical instruments.

然而这间手术室里除了苏利文医生之外还有另一位主刀医师,只不过这位医生穿得比我们任何人都舒服些。它的中央吊杆和白色的手臂上戴着塑料的“袖套”,这位医生就是Intuitive Surgical公司的“达芬奇Xi”机器人手术系统了。乍一看还真不好说这里谁说了算。 

As it happens, there’s another surgeon in the room beside Sullivan—one more modestly garbed than either of us. Wrapped in plastic sleeves that cover its central boom and sprawling white arms is Intuitive Surgical’s da Vinci Xi robotic surgery system. It’s hard to tell who’s in charge

深入病人体内的仪器包括三个独立可互换的部件,它们可以切割、移动、抓握、烧灼甚至操纵人体组织。此外还有一个可移动的高清摄像机,它能以惊人的3D清晰度显示病人体内的情况。苏利文表示,这种视觉上的优势已经革命性地改变了医生进行微创手术的方式。现在医生们已经不需要把人开膛破肚来摘除某个组织或采集样本了。

The instruments inside the patient include three separate, interchangeable components that can slice, shift, grasp, cauterize, or otherwise manipulate human tissue, as well as a movable high-definition camera that illuminates the body’s internal landscape in stunning 3D clarity. That’s a visual advantage that Sullivan says has revolutionized how doctors perform minimally invasive surgery—the kind that doesn’t require chopping someone open to remove a body part or collect samples.

苏利文走到手术台左边的控制台,坐在了一个取景器前面。这个取景器很像某种具有未来主义色彩的游戏机的屏幕。他用两手的拇指和中指放到两个移动臂的圆环上,控制台的下面有几个踏板,看起来有点像手动档汽车的离合器。通过手指和脚的操作,苏利文就能控制这四个医疗器械在病人体内的活动,并且可以在手术器械和3D内窥摄像机间任意切换。

Sullivan makes his way to a console on the left side of the OR, where he takes a seat in front of a viewfinder that looks like it belongs in a futuristic video game arcade. He places his middle fingers and thumbs into two pairs of rings on two movable arms. At the console’s floor are foot pedals, which function like a clutch in a manual car. With his fingers and feet, Sullivan will navigate the four instruments now inside the patient’s body—alternating between the pincer-laden surgical extensions and a 3D endoscopic camera. 

接下来的几个小时,他要使用达芬奇系统切掉病人的一个淋巴结进行病理分析(这个病人患有淋巴癌)。 

Over the next few hours, he’ll use the da Vinci to cut out a lymph node from the patient (who suffers from lymphoma) for lab testing.

两个小时后,我问苏利文,这个病人需要多久才能出院。 

Two hours later, I ask Sullivan how long it will be before the patient is discharged from the hospital. 

他反问我:“你住在什么地方?” 

“Where do you live?” he asks.

“纽约布鲁克林的布什维克。”我答道。 

“Bushwick, in Brooklyn,” I reply.

苏利文笑了:“他可能比你先到家。” 

Sullivan chuckles. “He’ll be home before you.”

科幻作品中历来不乏机器人医生的身影。虽然我们离“有病找安卓”的日子还有很远,但机器人参与手术却已经不是什么新鲜事了——当然,如果你不是外科医生的话,或许会觉得挺震惊的。加州森尼维尔市的Intuitive Surgical公司的机器人手术系统早在2000年就率先获得了美国FDA的批准,不过它的流行却还是最近几年的事。很多外科医生表示,该系统使他们能更清楚地看到病人体内的情况,同时也能对医疗器械进行更好的控制。 

Futurist culture has no shortage of fever dreams starring robot doctors. This story isn’t about that. While we’re still a ways from the day when androids become our go-to physicians, robotic surgery is already commonplace—and probably surprisingly so, if you don’t happen to be a surgeon. Intuitive Surgical (ISRG, -0.51%) , headquartered in Sunnyvale, Calif., got the first-of-its-kind clearance for its robotic surgical system from the Food and Drug Administration back in 2000. But it has been largely in the past few years that its machines have exploded in popularity. Surgeons who tout the tech say it’s given them a far clearer view of what’s happening inside the body and greater control over their instruments.

Intuitive Surgical 的设备现在已经广泛应用于美国所有的顶尖医院中,其应用领域涵盖了肿瘤科、泌尿科、妇科、消化科等等,美国许多顶尖医疗机构和院校,如纽约的纪念斯隆凯特琳癌症中心、梅奥诊所、约翰霍普金斯大学和克利兰医学中心等都采购了该公司的机器人手术设备。截止到今年6月30日,全球已有4100多台达芬奇系统投入使用,其中有2,703台在美国,698台在欧洲,538台在亚洲,还有210台分布在世界其他地区。

Intuitive’s devices are now used at all of the top-ranked U.S. hospitals for cancer, urology, gynecology, or gastroenterology—including venerable institutions like New York’s Memorial Sloan Kettering Cancer Center, the Mayo Clinic, Johns Hopkins, and the Cleveland Clinic. More than 4,100 da Vinci base units have been installed worldwide as of June 30, including 2,703 in the U.S., 698 in Europe, 538 in Asia, and 210 in the rest of the world.

这样一套系统可是不便宜的,第四代达芬奇系统的单价是190万美元,还不包括各种手术配件的费用,这些配件的价格也高达数万美元。尽管如此,达芬奇系统的销路依然火爆,越来越多的医生都开始用它做手术了。 

The systems aren’t cheap: The list price for the fourth-generation da Vinci Xi is $1.9 million, and that doesn’t include the cost of various surgical appendages, which can add tens of thousands of dollars more to the price tag. Still, the robots keep selling—and surgeons are increasingly adopting them in their practices.

公司的CEO加里·古塔尔特告诉《财富》记者,自2000年以来,达芬奇系统已经完成了400余万例微创手术,全球每隔42秒钟就会启动一台由达芬奇系统主刀的手术。2016年,达芬奇系统在全球执行的手术数量较上年增长了15%,预计2017年还会在2016年的基础上继续增长14%到15%。对于某些较复杂的手术,比如前列腺彻底切除术等,由机器人辅助的手术已经占到了手术总量的近90%。 

The company says that more than 4 million minimally invasive surgeries have been performed with da Vinci systems since 2000—a new one begins every 42 seconds somewhere around the globe, Intuitive CEO Gary Guthart tells Fortune. The number of those procedures done worldwide spiked 15% in 2016 compared with the previous year, and Intuitive pro¬jects an additional 14% to 15% rise in the number by the end of 2017. Indeed, for certain more complicated procedures, such as radical prostate removal, robotic-assisted surgeries now account for nearly 90% of operations.

随着机器人外科医生的普及,2016年,Intuitive Surgical公司的全球营收入达到了27亿美元,其中有超过70%的销量是自然形成的,这也突显了该公司在这一快速增长的市场上作为先行者的优势。 

The boom has driven Intuitive to $2.7 billion in 2016 global revenue, with more than 70% of sales being recurring in nature—a fact that underscores the advantage that comes from being the first major player in a rapidly growing market.

达芬奇系统的火爆也吸引了投资人的关注。2017年,Intuitive Surgical公司的估值已经暴涨了70%,其市值已经接近400亿美元大关。

That’s been a draw for investors too; in 2017 alone, Intuitive’s valuation has soared more than 70%, pushing its market capitalization near the $40 billion mark.


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