Transcriber: Ai Tokimatsu Reviewer: Yuko Shirakawa
Today I'd like to talk about Bio-Texture Modeling.
Until 2004,
I was a surgeon in Tokyo
at the big university.
And everyday, I did surgeries and outpatient care,
and basic research until midnight.
In 2004, I moved to a local hospital.
It didn't have high tech infrastructure.
But I was busier to change my mind.
Medical Informatics including medical images we must read
are increasing day by day.
Improvement of business efficiency was needed.
Now medical images can be reconstructed to 3D virtual reality
but medical computing software and hardware
require extra cost and knowledge.
It's little bit hard to do by the physicians, right?
So I found an open-source DICOM viewer OsiriX
developed by the physicians at the Geneva University.
And I got surprised and I wanted
to join their development team.
So I moved to the Geneva University.
OsiriX is easy to operate
for 3D reconstruction like this,
even by the physicians, even for the stereo 3D.
This is like a 3D images but it is not 3D,
so please put your glasses on.
So I turn this image into real 3D.
Like this.
Can you see that?
(Audience) Wow!
This image is a computer graphic.
It's from a CT scan image
from real patients.
And this are the abdominal organs.
You can see the pancreas here
and the arteries, vessels, the kidney,
and the spleen.
And you can also see the ribs and the bones.
From the surgeon's viewpoint,
it was very useful to be able to find the hidden cancers
by making organs transparent
and rotating them in 3D.
So I put these images into the operating room.
So a young surgeon can watch these images during the real surgery.
Beginner surgeons can perform a correct procedure.
This is good for education.
And I use it more friendly.
A wireless remote can be adopted into this Osirix system,
so we can do the 3D reconstruction during surgery.
I used this during real surgery,
As a surgeon doesn't need to push the button but only move it.
I could find the Japanese wireless motion sensing technology.
(Laughter) (applause)
I took it for wireless fluctuation adjusting accelerometer
for the laparoscopic surgeries.
We have also developed the functions
that used image guided navigation to guide a laparoscopic movement
when inserted into an abdomen by using an accelerometer.
Here you can see.
Just like a car navigation, right?
When I move the laparoscope,
the OsiriX navigation will go on the same direction in sync.
By using this method, a surgeon can execute an entire surgical operation
through an endoscope in conjunction with an ultrasonic technology.
This minimally invasive surgery is
safer, certain, and easier [to use] on the patient's body.
To make it more intuitive, we need to overcome the gaps
between the virtual reality and the actual images.
Here [you can see] the gap between the real image and actual image.
And the virtual reality,
the answer is very simple:
I put those images onto the patient's body surface
by using the projection mapping.
I named this 'image overlay'.
This image [was obtained with a real patient's permission].
So you can see through the abdominal organs
on the patient's body surface before cutting the abdominal wall,
so we can reduce the length of the incision line.
It is called a minimally invasive surgery.
In an augmented reality field within a real-time environment
we developed a method that enables images from the endoscope
to follow the camera movement on the CT-scanned 3D images.
It could be seen even onto the patient's body surface by projection mapping.
This patient had you know, appendicitis, an inflammation in the cecum and appendix.
This patient was a young female,
we needed to reduce the length of the incision for cosmetic result.
So we did this surgery with within an half inch incision.
However, this time we can touch the images,
but we cannot grasp the images.
I think this technology should be used for everyone.
in 2006 to 2007,
we put these images into the iPod, not iPad.
It is good for the student's education because they can have fun.
In the outpatient, it is easy to remove and then to rotate these 3D images.
Because the size of the device is very small,
we can put this device into the ambulance car and helicopters.
I put these functions into the helicopter.
There're apps for that.
You can see the iPad in the helicopter.
You can see the 3D images in the air.
And this is good for the education of the nurses in the hospital,
and good for the informed consent to the patient and the patient's families.
Even into the operation room.
Today, this technology can be adapted and fully utilized in medical activities
such as safe and precise surgery.
Even more, I developed the sterilized bag.
This is a water proof bag for the iPad.
We can put the iPad into the OR with the sterile plastic gloves.
And this is available for the kitchen, on the beach, and in the bath.
not in the bathroom, Japanese bath, right?
In our Kobe University,
every student can own their own iPad
during the medical round.
It is good for the fun of learning.
We can offer the students fun.
We could have touching experience into the body.
And I also developed this white coat with iPad.
(Applause)
And scrub.
(Laughter) (Applause)
This is the world first scrub for the iPad.
For sharing this idea,
we have been delivering this free open source application
worldwide from 2003,
and teaching it all over the world.
I made many manuals of this application,
and I made the DVD
for sharing this idea over the world.
And I translated it into Japanese.
And this is another question.
Medical doctors must secure not only the patient's healthy body
but also their soul.
Recently, we can visualize the human body using virtual reality
but, in visualizing their soul,
we need plus alpha.
From this perspective,
these plus alpha can vary in my development activities.
In the field of medicine, we need to translate the findings
in the basic research more quickly,
and efficiently into medical practice.
Thus, meaningful health outcomes
whether those are physical mental and social outcomes.
There is a question.
These technologies or virtual five senses
can really help the patient enough?
I think that's just the virtual reality, not real.
Then, I thought I wanted to handle the inner nature of things intuitively,
just like a sixth sense.
And then, we developed an advanced technology using a 3D printer.
3D and MRI images can be manufactured the actual size of the 3D organ modeling.
The specially designed gel-like support material
enabled each composite material to provide specific values of bio-texture like that.
It showed the human actuality beyond the virtual reality.
Using a multi-materials 3D printing system,
our biotexure modeling technology unabled
any combination with transparent or digital and flexible materials
to form the 3D organ structures and textures.
This yellow material is bio-compatible and can be sterilized.
I thought this could offer a better surgical guidance.
Immediately, I used this advantage for the real patient.
So, I selected the first victim,
it's me.
(Laughter)
I am the first patient.
I made the first evidence of the usefulness by myself.
By using the transparent material, it is possible to form models
that unable to see the bones and the vessels from the outside.
It is very persuasive materials for understanding the individual body
without difficult medical terminology even for the young generations.
The use of such biological models improves the accuracy of the operation.
We can discuss with the staff to decide the optimal procedure
by comparing the biological model and the organ during the operations.
For example, it becomes possible to simulate
a procedure before actual treating an organ.
We can cut it and repeat the surgical procedures
before the actual operations.
This modeling software can be designed the organ model
with tactile feedback intuitively.
Furthermore, we expected that the biological models formed
by the printer will help to educate the young doctors and nurses.
It can provide the living meaningful education.
So, it can solve the recent social problems in medicine.
Now the number of the surgeons is decreasing year by year, you know?
According to a surgeon's survival curve
they cannot survive more.
So, for this issue, we developed this robotic system.
When using it for robotic surgical simulation and training,
surgeons will be able to offer the most advanced surgical technologies
to their patients.
By monitoring the movement of the robotic surgery
and the model’s deformity,
it may improve their experiences of on the job training
even in the regional medicine and also the remote locations in space.
And for pregnancy, visualizing the unborn child
can decrease the mother's anxiety,
like this.
The parents must feel the symphony of life.
This is a meaningful gift.
Now I want to show you something.
Here.
This is the mother's body, a pregnant woman.
And here is the sleeping child. Here.
And you can handle the baby before birth.
(Applause)
A good gift.
(Laughter)
Good for all families.
And yourself.
You can make it.
Bio-Textual Modeling is the way to improve the world human life
by improving quality and efficiency, and preventing diseases
through better understanding of life and life-supporting activities.
Our combined technology of analogue and digital,
also the replace private prejudice and discrimination.
Finally, I would like to provide the medical ground design
by using the Bio-Texture Modeling.
It will put the human race forward
and advanced further innovations in medicine, and healthcare.
Thank you very much.
(Applause)