Medical Matters Muiris HoustonImagine you are 10kg overweight. You walk through a device that looks like an airport X-ray scanner. Seconds later you emerge minus about 2kg of fat tissue that has been "fried" by a laser. Then three days later, the fat will have been purged from your body, with no side effects apart from the need to resize your wardrobe.
Or let's say you need a hip and knee replacement. Data from magnetic resonance imaging scans (MRI) are fed into a computer programme. A stereolithography machine will then produce customised knee and hip parts, so that exact replicas of the original joints will be implanted by your orthopaedic surgeon.
Sounds futuristic? These scenarios are just two of a number of forecasts made by an American doctor when he was asked to predict new technologies that will change the practice of medicine.
All are existing technologies in various stages of development. The fat "fryer" is an example of a wave technology, while the customised joints represent the future impact of fabrication technology.
Donald Combs, associate dean at Eastern Virginia Medical School, was asked by the British Medical Journal to follow in the steps of Nostradamus by sharing his vision of medicine's technological future.
We already have devices that can sense and transmit heart rates and breathing rates.
Combs says the next application of biometrics will include the use of implantable sensors, capable of transmitting data on blood sugar and blood pressure thereby allowing remote diagnosis and treatment.
Further into the future, he foresees the sensors linking up with implanted drug storage dispensers which, when signalled, release the precise quantity of drugs required to stabilise the patient.
Medical robotics is another area with a seemingly bright future.
First conceived 20 years ago, the earliest use of robots in medicine was in neurosurgery, where they helped hold instruments at a specified location and orientation beside the patient's head.
In orthopaedic surgery, the Acrobot is a hands-on robot, designed to help the surgeon cut accurately. Research has shown that the robot can achieve great accuracy in minimally invasive surgery, such as the replacement of one of the surfaces of the knee joint (unicondyler knee replacement).
For soft tissue surgery, a telemanipulator robot called the da Vinci robot has been developed. The surgeon sits at a console next to the patient, who is operated on by the arms of the robot. The doctor views the internal organs by means of cameras inserted into the patient.
He uses the three-dimensional image to fine tune the robot's actions. The da Vinci system has successfully carried out heart surgery using small incisions in the chest wall. It is estimated that 10 per cent of hospitals in the US now have da Vinci robots.
The next development is likely to involve the use of robotic surgery over long distances. This may prove helpful in providing surgical services to remote communities. And from an educational perspective, surgeons in the future will be like pilots, who are now fully trained and tested in simulators before ever flying a real aircraft.
Of course, the problem with being a futurologist is that some of your prophecies will inevitably be wrong. But a review of predictions made 20 years ago by a panel of medical specialists has shown that most of their estimates were right.
In 1986, some 227 of the world's leading clinical scientists were asked to predict what medical advances would be achieved by the early 21st century. They accurately predicted the current cure rate for cancer at 65 per cent. With the exception of bowel cancer, the experts correctly predicted the tumours for which survival would improve some 20 years later (such as breast cancer, leukaemia and lymphoma).
However, most were wrong when they said we would now be vaccinating people against certain types of cancer.
How did the experts do in the field of cardiac medicine? They correctly predicted the routine use of "clot-busting" drugs in people with heart attacks.
The expansion of angioplasty - using balloons to open up blocked coronary arteries - was accurately foreseen; but the experts were far too optimistic when it came to the effect that nutritional advice would have on the problem of obesity.
On the infectious diseases front, the experts thought a safe and effective vaccine against HIV would be available by 2000. But they were right in predicting that there would be no cure for the common cold and that measles would not be eradicated by now.
Although they never saw Viagra coming, the expert group generally erred on the side of over-optimism. Will the same be said of Comb's predictions in 20 years? Or will the pace of technological change be even greater than he envisages?
Time will tell.
Dr Muiris Houston is pleased to hear from readers at mhouston@irish-times.ie but regrets that he cannot answer individual queries.