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Closing in on Industry 4.0

Digital Brains Aid in Farming and Surgery

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Digital Brains Aid in Farming and Surgery

Source:Chien-Tong Wang

Robotic arms in operating rooms are old news. But now digital brains are taking on greater roles independent from human operators, serving as assistants during surgical procedures, and also helping farmers tend their vegetable fields.

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Digital Brains Aid in Farming and Surgery

By Monique Hou
From CommonWealth Magazine (vol. 624 )

The Netherlands is a global trailblazer when it comes to the digitization in the field of biosciences and healthcare industry. The Dutch clinical teaching hospital Reinier de Graaf, which has its main location in the city of Delft, is a world leader for its collaboration with the ICT industries.

A traditional surgical team is comprised of an operating surgeon, a resident or intern, a physician assistant, an anesthesiologist and two nurses. Often the whole team needs to stand in the operating room for many hours while carrying out a surgical procedure.

One Robot Replaces Entire Team

In contrast, at hospital Reinier de Graaf, no one stands next to the patient on the operating table. The patient is surrounded by digital medical equipment whose settings have been adjusted by the nurses ahead of the surgery based on the patient’s health condition and surgical needs. Four robotic arms belonging to a daVinci surgical systems for minimally invasive surgery are moving over the patient’s body at the incision site.

Nearby, a physician assistant stares at the monitor of a central imaging system. Operating surgeon Maarten van der Elst sits at an ergonomic control console closely watching the magnified 3D HD view on the vision system and controlling the movements of the robotic instruments via a joystick-like operating lever. If it wasn’t for the sedated patient in the back, he could be playing a video game.

The operating surgeon no longer needs a nurse at his side to hand him instruments and materials because the robotic arms are connected to multifunctional precision instruments such as scissors, clamps, tissue separators, needle holders and electrosurgical equipment.

The robotic arms are more agile than the hands of a surgeon and can translate the surgeon’s movements into smaller, precise movements inside the patient’s body even within very confined spaces.

Birth of the Digital Surgical Assistant

Such surgical robots are no longer a rare sight. More than 1,200 daVinci systems have been delivered to hospitals around the globe. Hospital Reinier de Graaf stands out because it is collaborating with the Department of Biomechanical Engineering at the nearby Delft University of Technology. Together they developed a digital operating room assistant (DORA), which helps monitor the highly complex operating room environment.

DORA analyzes, diagnoses and monitors data from all medical instruments in operating rooms, incubators, intensive care units and cancer wards in the hospital. At the same time, the system constantly compares the collected realtime data against patients' medical records, monitors changes in a patient’s condition and the operating status of medical equipment. In the operating room, the system monitors the entire surgical procedures to identify potential risks.

Head nurse Aline Teekema notes that although she is in her fifties, learning to use DORA and several other advanced digital instruments did not pose a challenge for her.

In fact, the sophisticated equipment has markedly eased the physical burden of the job, which means that nurses can work in their careers longer than before. Yet she admits that “Without doubt, manpower demand will decrease.”

Have professional and occupational skills requirements changed due to the advances in medical robotics? Regarding this question, van der Elst recalls an experiment they tried with two groups of people; one consisted of medical school students, and the other of electronic game champions. They let the two groups of students solve certain problems faced by digital medical care; they found that the medical school students were more able to also take the patients into account, while the gamers’ mindset was more geared toward the euphoria that they felt when reaching the next level in an online game. But there was no doubt, van der Elst adds, that the medical school students still needed to strengthen their IT expertise.

Thanks to artificial intelligence and virtual reality, remote surgeries are already reality. Van der Elst, however, had to pass up an opportunity to remotely operate on a patient in France because Dutch law does not allow such procedures. The surgery was eventually carried out by a remote physician in Canada.

However, not only is such costly equipment like the daVinci robotic surgical system changing the work environment and the staffing requirements in hospitals. Smaller changes are also altering the workplace in medical care.

In traditional endoscopy, for instance, the physician no longer needs an assistant at his side because the endoscope is now held stable by a robotic arm that is manipulated by the surgeon himself, not the assistant.

“Endoscopy requires a very long period of time. The job of the assistant was to hold and manipulate the endoscope while the physician conducts the surgery. Endoscopes are very heavy; they weigh more than two kilograms. Holding it over a long period of time is exhausting; your hand will shake and tremble, which will cause the image to flicker, making the physician dizzy. Just a small lapse of attention can cause bleeding in the patient,” notes Tung Cheng-wei, manager at the Project Development Department of the Taichung-based precision machinery maker Hiwin Technologies Corp.

The robotic endoscope holder that Hiwin developed in cooperation with Show Chwan Memorial Hospital in Changhua in central Taiwan allows physicians to manipulate the endoscope with foot movements all by themselves and provides stable views from inside the body.

The continued development of similar intelligent medical equipment is making some jobs obsolete. But even remaining medical personnel need to learn new skills and undergo further training to be able to work with intelligent digital instruments and equipment. This is an irreversible trend.

These Crops Can Speak

“Our crops can talk themselves; they tell us what they need,” remarks Lex Wubben, the owner of four agricultural companies. “We only do what the computer tells us to do, and our crops grow very well. Farmers don’t need a green thumb, they only need a green eye,“ notes Wubben.

Aside from being an agricultural entrepreneur, Wubben, who is in his early forties, doubles as a manager at Demokwekerij Westland, the most important R&D center for applied technology in horticulture in the Netherlands.

The southern Holland municipality of Westland, located between The Hague and Rotterdam, is known as the “glass town” because it boasts the world’s largest expanse of horticulture greenhouses. Demokwekerij is housed right in the middle of this greenhouse belt.

The center is a collaboration between academia and industry.

Nearly 40 companies are executing research projects using Demokwekerij facilities and expertise to test the latest technologies.

Not a single human is visible inside the 5,000-square meter complex. Only two young employees work in front of computer screens in the small control room.

Inside the greenhouse compartments, plants are suspended from the ceiling at a height of one meter in cultivation beds that can be lowered to the floor when needed. This allows the staff to check crops such as tomatoes for ripeness and more conveniently pick them.

The greenhouses use a fully automated watering system that dispenses the exact amount needed. As a result, the tomatoes grown here require only one twentieth of the amount of water that is required in conventional cultivation.

Inside the greenhouse, temperature, plant growth, pests, lighting, the growing medium’s nutrient content, humidity as well as atmospheric changes are all monitored and controlled round-the-clock by a computer system.

Based on the results of the data analysis, lighting and temperature in the greenhouses are automatically adjusted using misting or dehumidifying systems for cooling or warming. Relevant data is processed through programmed operations and sent to the computer monitor in the control room, where the actual situation and potentially necessary intervention can be seen at a glance.

Demokwekerij has already exported its horticulture 4.0 solutions to Australia, China and Mexico, where farmers have committed large acreages to this collaboration.

Translated from the Chinese by Susanne Ganz


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