Modern medicine is pretty incredible.
But even in a world where open-heart surgery
and brain-scanning headsets sound almost mundane,
some medical advances do truly
seem like science fiction.
So here are five recent developments
that sound like they’re straight out of the future,
but are already around today.
Robots and surgeons go way back—
in fact, robots have been in operating rooms
since the late 1980s,
helping out with all types of routine procedures.
But in February 2020,
surgeons in the Netherlands kicked things up a notch.
They used a very precise robotic arm
with teeny tiny tools on the end
to operate on blood vessels just a few times the size of a human hair.
It was the first human trial
of robot-assisted supermicrosurgery,
which is surgery on vessels smaller than eight-tenths of a millimeter.
Surgeries at these scales are really tricky for humans,
because our hands do shake— maybe just a little bit,
but at these scales, every millimeter counts.
So only highly-trained surgeons
are capable of doing these procedures.
One of these very precise surgeries,
called a lymphatico-venous anastomosis, or an LVA,
is a treatment for breast cancer patients
whose lymph isn’t draining properly.
Lymph is a fluid that transports white blood cells
and other nutrients around the body—
and when it doesn’t drain properly,
it can cause swelling and pain.
But with surgery, tiny lymph vessels can be connected to blood vessels
to give the lymph another way out.
This surgery is at the very limit of human capabilities,
but the team of surgeons and roboticists in the Netherland
thought they might just be able to
make the procedure easier and safer.
They devised a robot called MUSA,
which mimics a surgeon.
It has two arms that go over the patient,
with tiny surgical tools on the ends instead of hands.
To manipulate the robot,
a surgeon looks at the patient through a microscope
and moves a set of controllers
as if they were operating directly on a person.
But it’s the robot’s tiny tools that are actually performing the surgery.
The robot mimics the surgeon’s movements exactly,
except it filters out tremors.
It also scales those movements down,
since the surgeon is looking at the patient through a microscope
and making bigger motions.
Out of 20 surgeries, MUSA assisted in eight,
and all of them were a success.
Unlike a human, the robot didn’t twitch or get tired,
and it could hold an awkward position forever if it had to.
This success is really exciting,
because a robot like MUSA could
make this type of complex surgery possible for more surgeons—
which means more people could get the treatment they need.
The reason a lot of people who are paralyzed can’t move their limbs
is because the nerves that should be taking signals
from the brain to the rest of the body
aren’t working the way they should.
And for many people with this kind of nerve damage,
the condition is permanent.
But in a case study published in 2019 in the journal
The Lancet Neurology,
a team of researchers in France found a creative way
for a man who was paralyzed below the neck
to control his limbs again.
Their idea was to bypass the nerves completely—
by recording messages straight from the brain
and sending them to a machine that could carry out its orders.
The solution combined incredible advances
in both brain scanning and robotics.
First, the team inserted two small implants into the patient’s brain
to measure activity in the areas that control movement.
The implants were hooked up wirelessly to a computer system,
which decoded the brain signals
and translated them into instructions
for a virtual avatar or a full-body exosuit.
But it was not as straightforward as it sounds.
See, scientists know which regions
of the brain broadly control movement,
but for this contraption to work,
the system needed to match up an exact pattern of active brain cells
with a specific movement.
And that’s not exactly easy.
Like, what does [this] look like on a brain scan, compared to, like, [this]?
The team started by having the patient think about a specific action —
like rotating his wrist or moving a wheelchair forward.
The computer—which was hooked up wirelessly to his brain—
would record the signals that thought created.
Then, over the course of two years,
the computer created a model of the patient’s brain—
basically like a dictionary that matched brain patterns to movements.
In a way, he was both training the computer
to understand his brain signals,
and training himself to think in a structured and focused way
that a computer would understand.
And in the end, the patient was able to use the system
to do all sorts of things!
He drove a wheelchair and made virtual hands do things
like turn over or touch a target.
He also gained the ability to start and stop an exoskeleton.
It was attached to a harness mounted on the ceiling,
so while he wasn’t completely independent,
he could essentially walk.
Now, this wasn’t the first time scientists created an interface
between a brain and a computer,
but the small surgery it required
was much less invasive than other methods.
And while it’s still a long ways from widespread use,
it’s a big step toward developing a way for paralyzed people
to control robotic limbs with nothing but their thoughts.
In March 2020, doctors in Oregon announced that
they had used the DNA-editing tool CRISPR-Cas9
in a living person for the first time.
Their goal was to treat a rare genetic condition that causes blindness
by just fixing the faulty code in the DNA.
Which is actually possible
because Cas9 is an enzyme that can cut apart molecules,
and it allows researchers to snip a strand of DNA
at a precise location
and replace faulty code with new instructions.
This technology itself isn’t that new.
Scientists have been using it to edit genes
in bacteria, fruit flies, plants, and other organisms since 2013.
编辑细菌 果蝇 植物和其它生物的基因
And in a different study, also published in February of 2020,
doctors actually edited the white blood cells of three people with cancer—
but they did the editing outside the patients’ bodies.
That same month, though,
the team in Oregon took gene-editing a step further
when they announced that they had used it directly in the human body
to edit the genes of living cells—
although when we filmed this video,
they didn’t yet have their results.
This clinical trial involved a patient
with a rare inherited eye disease
called Leber congenital amaurosis,
which affects the cells of the retina and causes blindness.
And this disease can be caused by
a mistake in a gene called CEP290 –
that’s what researchers wanted to fix.
In the trial, doctors used a needle to inject a few drops
of a solution containing the CRISPR-Cas9 system
into the space just behind the retina.
The idea was that CRISPR-Cas9 would find the cells of the retina
and snip away the mutation,
leaving behind a functional gene.
If it works, it should be a permanent cure.
And the retina is a good place to test out gene editing in humans,
because it’s isolated from the rest of the body—
so changes made on one eye won’t affect any other part of the body.
After all, there are a lot of valid reasons
to be concerned about doing gene-editing in humans—
but this is a pretty safe place to start.
And if the procedure does cure the patient’s blindness,
it’s not just good news for people with this rare disease;
it could open up the possibility for other gene therapy treatments as well.
These days, there’s not much you can do
if you scrape up a knee or get any injury that breaks the skin.
It’s just got to heal, and it takes as long as it takes.
But in 2018,
researchers at the University of Wisconsin-Madison
reported that they had built a device
that healed injuries in rats four times
faster than they heal on their own.
The device itself is really simple:
It’s basically a little electric bracelet
that delivers gentle electric pulses to the site of an injury.
Now electricity naturally plays a role in helping wounds heal.
Scientists have known since the 1800s that
anytime you get an injury,
your body naturally creates an electric field around it.
And in more recent studies, researchers have even watched
cells move around and restructure themselves
in response to an electric field.
You know. As they do.
They still don’t know exactly
how the cells are responding to that electricity,
but electricity seems to promote the growth of new cells,
which is what it takes to close a wound.
So this device was designed to speed up healing
by providing additional electricity to the injured region.
And in rats, the results were kind of incredible.
An injury that normally took almost two weeks to heal
closed up in three days.
Eventually, researchers hope to
test something like this on human skin.
And in the meantime, they’ve found evidence that
this technology may even have an extra perk—
it might reverse baldness.
In a separate experiment,
they applied a patch with the same technology
to mice with a genetic condition
keeping them from producing certain chemicals that make hair grow.
So the mice are naturally hairless,
but after just nine days,
they’d grown hair under the electric patch.
Researchers believe the patch works
by stimulating the cells in the area
so they release those chemicals that tell hair to grow.
Now, you may have noticed that
your head is not mouse skin.
But if tests in humans go well,
products with this technology could eventually hit the market,
but in the meantime— in case you need me to say it—
don’t try this at home.
Everywhere around the world,
there are more people who need organs than there are donors.
Like, right now, there are over 100,000 people in the U.S. waiting for kidneys.
And even in a record-setting year like 2019,
fewer than a quarter of those people will get them.
So lives depend on finding more kidneys.
And in 2015, doctors in the U.K. found a new way
to put kidneys from deceased donors back in business,
using a technique called ex-vivo normothermic perfusion.
This technique uses a jolt of nutrients
to repair kidneys from deceased donors
and make them usable again—which is not easy.
Because, as soon as a person dies, their organs start to deteriorate.
Doctors can slow that deterioration by chilling an organ,
but even then, kidneys have to be transplanted within a day or two,
or they’re often too far gone.
This new procedure helps by putting new life into kidneys
that have passed the usual point of no return.
First, the kidney gets removed from the deceased donor
and kept cold, just like usual.
Then it has to travel—
sometimes down the hall, other times to a different city.
Once it gets where it’s going,
it goes into a special machine that’s kind of like a spa
But for kidneys,it pumps warm blood and nutrients
through the organ until it’s working at peak efficiency.
Then it’s good to go back to work in the world of the living.
What’s cool about this procedure is
it doesn’t just wake the kidney back up—
it also gives the surgeons a chance to make sure
the kidney works on a machine, before it goes into a human.
Kidneys that were borderline become healthy enough
to use after this little trip to the kidney spa.
And, so far, the early results are promising.
Initial studies show that the revived kidneys are at least
as safe as kidneys typically used for transplants.
Other trials are still in progress to make sure it’s completely safe,
but if things go well, this could save a lot of lives.
For now, many of these advances are proofs of concept
and still far from being your everyday reality,
but they show how quickly science fiction can become science
and help us to live longer, healthier lives.
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