Google Cloud Speech-to-Text API (Chirp) + Gemini 2.5 Flash Non-Thinking. Treat it as a searchable index of what was broadcast, not a quotation record.
00:02:05nothing impossible if you set some
00:02:09goals for yourself, and we have a whole team setting these goals,
00:02:13then we will definitely
00:02:13achieve them,
00:02:18and we will bring a giraffe, and
00:02:21a hippopotamus, and someone else.
00:03:01Several punctures measuring a couple of millimeters,
00:03:05a camera seeing more than human eyes and
00:03:09robot hands that do not shake, do not get tired help
00:03:12doctors act with jeweler precision, even with
00:03:16complex diagnoses. All this is modern
00:03:19surgery, more precisely, one of its directions, minimally
00:03:23invasive surgery, popularly known as gentle. We will try
00:03:27to understand this topic in
00:03:30the next half hour. My name is Ekaterina Beretskaya,
00:03:33hello. Watch today in
00:03:36the program: from barbers with razors to
00:03:40the da Vinci robot, how surgery has changed over
00:03:43the centuries, I will tell you in the history
00:03:46of the issue. Gentle alternative,
00:03:49indications and advantages of minimally invasive
00:03:52surgery, we will discuss with specialists
00:03:55and the robot in the operating room, let's see what
00:03:58the machine is capable of.
00:04:05For a long time, surgery remained a very risky method of
00:04:08treatment. When exactly did the situation change, who
00:04:12contributed to this, I will tell you right
00:04:16now.
00:04:24The first surgical operations were carried out in ancient
00:04:27Egypt. Doctors opened boils, corrected fractures and
00:04:31even performed trepanation of the skull using
00:04:34stone and bronze instruments. In the ancient
00:04:37world, there were their own medical methods, operations were performed
00:04:41even for cataract and hernia removal. After the fall
00:04:45of Rome, surgery for a long time was not considered a science, but
00:04:48a craft, and the right to operate for a century
00:04:52passed to barbers. But even if operations were performed by
00:04:56more or less trained practitioners, until the 19th
00:04:59century it was
00:05:01a survival test. Anesthesia was first applied only in
00:05:041846, antiseptic a year
00:05:08later. At the beginning of the 19th century, a German doctor, Philipp.
00:05:16a tube with a candle and mirrors for examining
00:05:18organs. In 1901, a German
00:05:22doctor named Kelling inserted a tube with optics
00:05:25and air through a puncture in a dog's abdomen. And in
00:05:291910 the Swede Hans
00:05:32Jacobaeus performed a similar procedure for
00:05:36the first time on a human. He essentially performed the first
00:05:39laparoscopy. In 1980.
00:05:45used the method not for examination, he removed the appendix
00:05:49using this method. At the end of the century, the method began
00:05:53to spread throughout the world as a minimally invasive alternative
00:05:57to open manipulations. In parallel, in
00:05:59the USA, the idea of remote
00:06:02surgery originated. The development was financed by the army
00:06:05department, doctors dreamed of operating on the wounded
00:06:08right on the battlefield. In 1990.
00:06:12research at Stanford Institute led to the creation
00:06:16of the first surgical robot, which became
00:06:19the prototype of the da Vinci system released 9 years
00:06:22later, named after the famous inventor. In
00:06:26the early 2000s, the system was approved for use in
00:06:29gynecology, urology, cardiac surgery and
00:06:32oncologic surgery. In Belarus, laparoscopic operations
00:06:36began to be performed in the nineties of the last century,
00:06:39so today no one will be surprised by them. But
00:06:43a robot in the operating room can still surprise
00:06:46you. The first robotic surgical complex in our
00:06:49country appeared in the Minsk Scientific and Practical
00:06:53Center for Surgery, Transplantology and
00:06:55Hematology. Today, smart machines
00:06:58already work in the operating rooms of several clinics
00:07:01in the country.
00:07:09Technology promises accuracy and efficiency, but... what is
00:07:13it like to trust a machine and share responsibility for
00:07:16the result? To help us understand is urologist of the highest
00:07:19qualification category of the Minsk Scientific and Practical
00:07:23Center for Surgery, Transplantology and Hematology, Sergey
00:07:26Lyubetsky. Sergey Alexandrovich, hello. Hello. Well,
00:07:30let's start with the conceptual. What are
00:07:32the main advantages of minimally invasive
00:07:35surgery? Well, in fact, the main advantages
00:07:39are already hidden in the name itself.
00:08:13Its treatment endoscopically, minimally
00:08:16invasively, but it should be noted that this can only be done
00:08:19in the initial manifestations of the disease; in severe
00:08:22advanced cases, of course, it is not always possible to apply certain
00:08:26minimally invasive methods. Contraindications still
00:08:30exist, despite the fact that medicine is not
00:08:33standing still and is developing,
00:08:35but there are conditions of the
00:08:38cardiovascular system
00:08:41or... when the patient has serious respiratory
00:08:45system pathology, when it is impossible to perform complex anesthesia for
00:08:48surgery, and it should be taken into account that during
00:08:51laparoscopic or robotic surgery, the patient
00:08:55needs to have a large amount of carbon
00:08:58dioxide pumped into the abdominal cavity, which also has its
00:09:01negative effect and has its contraindications. Also,
00:09:05there are situations when the patient previously had
00:09:09repeated open surgical intervention... Therefore,
00:09:22in each situation, for each specific individual
00:09:25patient, the decision is made strictly
00:09:28individually. And how is the development
00:09:31of minimally invasive and robotic
00:09:33methods in surgery
00:09:37related to transplantology? Well, as is known, our center
00:09:40is a leading center
00:09:42in this field, in the field of transplantation and the introduction
00:09:46of minimally invasive technologies, of course,
00:09:50has also affected this area, and also
00:09:52performing laparoscopic organ retrieval, for example,
00:09:56a kidney from a living donor, allows the patient to recover
00:09:59faster and undergo
00:10:02this operation with minimal health costs for the body,
00:10:05including
00:10:09- our deputy director, Kolaychik Oleg -
00:10:55so that nothing happens during the operation, suddenly
00:10:58the robot doesn't break down, but of course we talk to the patients before the operation,
00:11:02explain everything to them, we explain to them
00:11:05that the robot does not operate, it's still the
00:11:08surgeon who operates, and the robot is
00:11:11just a high-tech machine, an instrument in the hands
00:11:14of an experienced surgeon, well, surely
00:11:17there aren't that many robotic systems in
00:11:20the world, right? But your center
00:11:23chose a specific one, right? Why
00:11:27were certain characteristics particularly taken into account, well,
00:11:30surely it was chosen based on what was needed
00:11:34specifically for your operations? Yes,
00:11:37of course, the choice fell on a robotic complex
00:11:40from a Chinese manufacturer,
00:11:43Medbot. This unit
00:11:46is characterized by the fact that it was originally designed
00:11:49to work in very narrow
00:11:52spaces, well...
00:11:56the manufacturer, among other things, provided us with such expanded
00:11:59technical support and training
00:12:03for specialists who work in the simulation center in China,
00:12:07so all the doctors who work
00:12:10on this unit, on this complex, we underwent
00:12:14training in a clinic in China in a simulation
00:12:18center, where we honed our skills before
00:12:21proceeding to the operating table, well on this...
00:12:25complex can
00:12:27a certain range of surgical interventions
00:12:31be performed or can
00:12:33it do everything? Well,
00:12:36in principle, this complex can cover all the
00:12:39pathology that we used to operate on openly, then we switched to
00:12:43laparoscopic operations, and now the robot allows us
00:12:47to do this, let's say, with better
00:12:50results. If
00:12:53we imagine what a scope is, we need to imagine
00:12:57a task before us, right, that, for example, we need to repair some complex mechanism
00:13:00inside a closed room, right, and we need to do all this through some
00:13:04keyhole, that's roughly what laparoscopy is, through
00:13:07small punctures ports are inserted into the human
00:13:10body, a laparoscope is inserted
00:13:14into one of them, it's a tube
00:13:17that has a camera at the end, a light source
00:13:20and the image is transmitted to the screen in the operating room, and through
00:13:23the other ports...
00:13:26instruments are placed into the patient, with which the surgeon
00:13:29operates, while controlling what he is doing on
00:13:32the screen. The robotic
00:13:36system in this regard has a few more
00:13:39additional functions, because laparoscopic instruments have
00:13:42a rigid axis,
00:13:45and a robotic instrument differs from a laparoscopic one in that it has 7
00:13:49degrees of freedom, and it actually repeats all the movements
00:13:52in the hand of the operating surgeon. I suggest
00:13:55we add some clarity to our conversation, my
00:13:58colleagues went, in fact, to your work to see the robot surgeon
00:14:02with their own eyes.
00:14:15Entrusting patients' lives to a machine is not an easy decision.
00:14:19It is not surprising that Belarusian doctors carefully considered robotic
00:14:22surgery, weighing all the pros and cons carefully.
00:14:55The practice of the Minsk Scientific and Practical Center for Surgery,
00:14:58Transplantology and Hematology, which was the first to acquire one of
00:15:02the best devices on the market, dispelled many doubts. The result was not
00:15:05long in coming. In just over six months, we have already performed about 200 such
00:15:09operations. The fields are
00:15:11diverse. It is generally recognized that the robot gives the greatest
00:15:15advantage in urology when performing
00:15:18urological operations, where it has already almost
00:15:21completely replaced laparoscopy. And the second
00:15:25thing is what is called surgery in hard-to-reach
00:15:28places, this is primarily the small pelvis,
00:15:32this is what is performed on the rectum and large intestine, and
00:15:35these are those operations that gynecologists
00:15:38perform. The next very important advantage
00:15:41of the robot are high-tech complex operations
00:15:44on the liver and pancreas. This is
00:15:47the specialization of our center. The complex consists of three parts:
00:15:51the surgeon's console, the doctor's workstation with joysticks, foot
00:15:54pedals and a 3D display. The unit with mechanical arms.
00:15:58It directly works with the patient. And the visualization
00:16:02unit that transmits images with 10x magnification. In
00:16:05laparoscopy, the surgeon is limited in
00:16:09the ability to perform movements due to
00:16:12physiological limitations in the joints of human hands,
00:16:16wrists, elbows. The robotic manipulator, it largely
00:16:20repeats the movement
00:16:23of human hands and arm joints, only with
00:16:26greater degrees of freedom or with
00:16:29greater capabilities of rotation in different
00:16:32planes. Thus, the robot truly
00:16:35provides a lot of...
00:16:38well, additional capabilities, but the robot itself does not
00:16:41perform any actions, full control is ensured by the doctor. All
00:16:45movements are performed on the patient only when the surgeon
00:16:47looks at
00:16:50the console screen, just as I am doing it now, there are
00:16:54sensors here that allow movements to be performed
00:16:57only when the eyes are looking at
00:17:00the screen, at this monitor. As soon as the head
00:17:04moves away, I will move the manipulators out of the area
00:17:06of interest. So that they are, for example, in the abdominal
00:17:09cavity suspended, at this time I move my
00:17:13head away from the screen and they will not be able to move,
00:17:17that's it, they are fixed, they won't touch anything by themselves.
00:17:20Force majeure is provided for. If the electricity goes out during the operation,
00:17:23the complex will switch to an uninterruptible
00:17:26power source and finish the operation in normal mode. Also,
00:17:30during the operation, a team of specialists, a surgeon's assistant and an operating
00:17:33nurse, are always near the robot. All to... avoid
00:18:13open surgery - this is also one of the important advantages of robotic
00:18:17surgery, because open surgery
00:18:20is accompanied by other trauma, worse
00:18:23tolerance, a different profile
00:18:26of surgical risk, that is, everything that is performed laparoscopically or
00:18:30robotically, that is, minimally invasively, is tolerated
00:18:33more easily by patients with fewer complications.
00:18:37And yet, the center emphasizes: no matter how perfect the technique,
00:18:40the result of the operation is determined by the human. They do not in any way, as of
00:18:44today, as long as they don't have artificial intelligence, replace
00:18:48the surgeon, and
00:18:51the success of the operation does not depend on
00:18:53the robot, it depends on how well
00:18:57a particular surgeon masters the technique
00:19:00of this operation, and masters this
00:19:03robot, how skillful he is, how well he can operate this robot.
00:20:09small plant, in the next stage, we make five more
00:20:13plants. Attention again, this is our inclusive
00:20:16project, we participate in many different charity events, generally,
00:20:20yes, and this project also became such a highlight for our
00:20:24building, that is, it was important
00:20:25for us.
00:22:14Surgical intervention online, reality
00:22:18or fantasy.
00:22:21And a special report from the program Science Festival
00:22:242026, how it was,
00:22:27we will show.
00:22:32We are back in the studio, and our guest is a doctor of the highest qualification
00:22:36category from the Minsk Scientific and Practical Center
00:22:38for Surgery, Transplantology, and Hematology, Sergey Lyubetsky. Sergey
00:22:42Alexandrovich, let's continue. We talked about patients,
00:22:45let's talk about you, the doctors.
00:22:49Here's a psychologist.
00:23:20As for emotional stress, yes,
00:23:23mental, after all, during robotic operations, it
00:23:26is higher,
00:23:30and this is due to the fact that these technologies are
00:23:33slightly different. When performing laparoscopic operations
00:23:37or open operations, there is tactile sensitivity, that
00:23:40is, the surgeon feels tissues with his hands, feels
00:23:43the tension of the thread, and so on. When the surgeon
00:23:47operates on a robotic system, he controls...
00:23:51and joysticks do not transmit that tactile
00:23:54sensitivity,
00:23:56everything that the doctor assesses with his hands at the operating
00:24:00table, he must assess visually,
00:24:03according to the parameters, probably, that the machine gives out, of course,
00:24:07and this requires such a very serious psycho-emotional
00:24:11stress and concentration of attention in the first
00:24:14place. On the other hand, physical stress,
00:24:17fatigue, it is, of course, less on the robotic
00:24:20system, because when an operation is performed
00:24:24at the table, right, the surgeon
00:24:26can be in some static, uncomfortable
00:24:30position for himself for a very long
00:24:32time, and as a rule, his hands,
00:24:35neck,
00:24:38everything gets stiff, right, it's impossible to stand for so
00:24:40long. On the other hand, when working
00:24:44robotically, the surgeon is in a
00:24:47comfortable ergonomic
00:24:51chair during the operation,
00:24:54which, of course, reduces physical fatigue after such operations. And
00:24:57let's talk about another phenomenon, such as
00:25:01surgical interventions at a distance,
00:25:04remotely. This is also a reality
00:25:08today, because once it
00:25:11was just fantasy. How does
00:25:13this happen? Well, at the moment it's an absolute
00:25:17reality. And our complex also
00:25:20has 5G modules that transmit
00:25:24a signal over long distances with minimal delay, and
00:25:28the delay is literally fractions of a millisecond, which are practically
00:25:31imperceptible to the human eye.
00:25:35This technology allows operations to be performed at
00:25:38a distance. The first such operations have already been carried out
00:25:42in our center, including, when
00:25:45the surgeon was here with us in Minsk, and the patient who
00:25:49was operated on...
00:26:04that in the future, the surgeon will not need to travel somewhere to perform
00:26:07a complex operation. It will be enough to sit at the console here in
00:26:11Minsk. Well, since we started talking about
00:26:14the future of surgery, here's
00:26:16a philosophical question for
00:26:18you, what will it be like?
00:26:22Well, I think that the human
00:26:25element in the operating room will always be there,
00:26:29without human intelligence, it's probably impossible.
00:26:34The only thing that will probably change is that the surgeon, from such
00:26:37a craftsman working with his hands, will already turn more into
00:26:41a mentor who will control the work of some
00:26:44artificial systems. Well, in my opinion, the
00:26:48decision,
00:26:51the difficult decision-making, will depend on
00:26:54the person, how to proceed in case
00:26:57of complications, for example, or with some
00:27:01peculiarity, a small structure.
00:27:05Most likely, the operating room of the future is such
00:27:08a kind of symbiosis of man and
00:27:11the precision of machines. Well, then, let's see what
00:27:15it will look like in 15 years, at least. Thank you very much
00:27:19for finding the time and coming to us and
00:27:22telling us, it was very, very interesting, thank you,
00:27:25thank you. And we continue, my young colleague
00:27:28Potap Matskevich went to the annual
00:27:31science festival in the Minsk Botanical Garden
00:27:35and was able to try himself, including as a
00:27:38medic. What he learned, we will find out right
00:27:41now.
00:27:49Become a biologist, chemist, and even a medic for one day? What
00:27:53a great opportunity to feel what it's like to save lives,
00:27:56make a new discovery, I went to the Minsk Botanical Garden.
00:28:00Science is just booming here, the festival has only just begun... and there's already so
00:28:03much interesting stuff, well, let's go figure it out.
00:28:07Let's imagine a situation: a person is choking in front of you. What
00:28:10to do? We approach him exclusively from the side, spread
00:28:13his legs, put our one leg in, then
00:28:17lean him over and with pushing
00:28:21movements do it five times, 1, 2,
00:28:243, 4, 5.
00:28:27We looked, but the food didn't come out,
00:28:30so we find the navel.
00:28:33Two fingers above, we make a fist and
00:28:35a hand. That's it,
00:28:39the foreign body that created the obstruction in our respiratory tract
00:28:42is removed. I try to apply the theory in
00:28:44practice. Young man, are you
00:28:47not feeling well?
00:28:56That's it, I helped. Good job, you provided
00:29:00assistance. It happens. Another situation: a person
00:29:04is unconscious, the ambulance has been called, but there's no time to wait,
00:29:07every second counts. It's necessary to immediately perform cardiopulmonary
00:29:11resuscitation. You have a bone here, the sternum, you can
00:29:15feel it, reach the edge of the bone, place
00:29:18two fingers, put your hands down, put your hands
00:29:22like this or like this, the main thing is to do it with straight arms, because
00:29:26often people bend their elbows and it turns out
00:29:29they work like this. If you work like this, then... you'll get tired
00:29:32very quickly. I try, hands in place, my task is to do 30 compressions and
00:29:36two breaths, and so on in a loop until the ambulance
00:29:39arrives.
00:29:46A few simple actions give a person a chance to wait
00:29:49for doctors. Thanks for the useful master class, and I'm going
00:29:52on.
00:29:55Hello, hello, I see you have many different interesting
00:29:58colored test tubes here, can you tell me what they are for? We have a mini-laboratory
00:30:02here, we teach people to use automatic
00:30:06dispensers, we use such dispensers in laboratories, they
00:30:09are necessary to measure the right amount of liquid, can
00:30:13I try? Yes, let's try. For the dispenser
00:30:16to work, put on the tip, immerse it in the liquid,
00:30:19done, the solution is inside, now transfer it to the desired test tube
00:30:23according to the same scheme, lower it, press the
00:30:26button all the way down, to the second stop. This is how
00:30:29scientists conduct analyzes and take the first steps in
00:30:33creating new medicines, and such dispensers are also used to measure solutions for
00:30:36droppers and drugs for anesthesia, here accuracy is