Let’s go hand in hand together beyond academic boundaries to explore cyborg technologies for hand surgery.
Few people argue against placing human beings at the apex of the animal kingdom. The excellent human capability is a product of an enormous number of natural selections occurring through three billion years of evolution. If the functionality of each body component is a judge, however, the human body is not necessarily the best on the planet. We can easily think of animals with stronger legs, longer distance vision, wider hearing ranges, or even longer life expectancies. What makes humans so special are three parts: the brain, the hand, and the vocal system. They closely collaborate with each other, thereby rendering human life so different from that of other animals. Compared to Australopithecus, thought to be the immediate ancestor of the genus that includes Homo sapiens, the brain of modern humans is triple the size. For this, the latter two structures are largely responsible. Our capability for vocal communication enables us to form and maintain functionally efficient societies through the transfer of thoughts and experiences that can extend generations. Brain size alone does not explain the position of humans at the apex. If intelligence is exclusively linked to brain size, it should follow that dolphins, with a brain size almost the same as that of humans, have similar intelligence. In fact, some researchers view them as a highly social species. However, they cannot assume a position on par with humans in the animal kingdom. Decidedly, the dexterous hand is an irreplaceable prerequisite for civilization. The hand is not a mere manipulator. It serves as an antenna to collect information, as a tool to drive thoughts and cast them into shape, and as a device to create and innovate. Therefore, disability of the hand, both congenital and acquired, is one of the most serious disadvantages for survival in the highly competitive human society.
Technology is defined as the application of scientific knowledge for practical purposes. The invention of the internal combustion engine in the First Industrial Revolution induced remarkable improvement in efficiency of manufacturing. Utilization of electric power led the Second Industrial Revolution where people's lifestyle had drastically changed. The digital revolution (the Third Industrial Revolution) replaced almost all basic tools for civilization and significantly expanded human capability. Throughout the history of technological revolutions, medicine has been a primary target for the application of emerging and evolving technologies. In fact, the introduction of key innovations such as anesthesia, disinfection techniques, blood transfusion, antibiotics, and monitoring devices invariably has resulted in drastic changes in surgical practices and even to the lifestyle of surgeons.
For the last two decades, revolutionary technologies such as robotics, artificial intelligence, biotechnologies, nanotechnologies, the internet-of-things, as well as information and communication technologies emerged one after another, swiftly incorporated into modern society. Even autonomous vehicles are no longer sci-fi. It has been suggested repeatedly that we are entering a Fourth Industrial Revolution. The current rapid pace of technological breakthroughs continue at an almost exponential rate of advancement. The implication for us is that surgery in ten-years’ time—even within the next five years—may be strikingly different from the current state. This may be especially true for functional reconstructive surgery of the hand, a surgical discipline dealing with such a formidably complex body system. I strongly believe the next stage of human evolution will not be biological but rather a surgically induced technological one, a merging of human body with autonomous machine, with resultant augmentation and enhancement of human ability. In the case of leg prostheses, world records at the Paralympic Games have almost caught up with those of the Olympics in a number of athletic events due to Fourth Industrial Revolution-type technological advancement. The research focus of leading engineers is already orienting toward the upper extremities, sites undoubtedly far more difficult because of their strong connection with the mind.
The purpose of the 1st International Symposium on the Intelligent Functional Reconstruction of the Hand is to provide an unprecedented opportunity for multidisciplinary discussion involving researchers wide-ranging backgrounds and perspectives. I invited leading researchers in the fields of hand and plastic surgery, allogenic tissue transplantation, regenerative medicine, robotic surgery, neuro-prosthesis, robotics, artificial intelligence, computer science, and information technologies from all over the world. I also encouraged young, active Japanese Society for the Surgery of the Hand members to participate in the two-day meeting. I hope this valuable opportunity supported by the Japan Society for Promotion of Sciences will generate perspectives on cyborg technologies applicable to surgery of the hand that is both promising and realistic. I also hope that this symposium will pave the way to enhanced collaboration among researchers in this emerging domain that transcends academic borders of academic specialization as well as geographical place.