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Robot surgery begins in SA

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Chantelle Gouws has became the first person in South Africa to undergo a partial nephrectomy using da Vinci robotic-assisted technology. The organ-preserving excision of a cancerous tumour from her kidney was done at Netcare’s Waterfall City Hospital in Midrand.

The 29-year-old from Springs also became the first woman to undergo a procedure using the da Vinci robotic surgical system in South Africa.

“I was nervous before I knew what was wrong with me. Now I’m not nervous at all. I have a really, really good doctor and was quite surprised when I found out my procedure would be a double first,” Gouws said, from her hospital bed shortly before her operation.

“It is amazing to know that medical technology has progressed so much. I’m now very calm and comfortable about the procedure because I know Dr Conradie will remove all of the tumour accurately,” added Gouws.

Her surgeon, urologist Dr Marius Conradie, said doing a partial nephrectomy was an extremely intricate and exacting procedure.

“There’s a number of blood vessels involved in the reconstruction of the urinary tract. Any mistake and the patient could bleed to death on the operating table,” he said.

Gouws’ tumour was diagnosed after an ovarian cyst burst about two months ago while she was at work. The cyst had gone undetected, as she had not been seeing her gynaecologist regularly. During an ultrasound examination by her gynaecologist the golf ball-sized mass in her right kidney was incidentally discovered.

Up until now urologists have been using the highly sophisticated technology, which was installed at Netcare Waterfall City and Netcare Christiaan Barnard Memorial Hospital to operate on men, mainly for the surgical removal of the prostate gland.

The system consists of a console where the surgeon sits, peering into a screen, using foot pedals and hand controls to remotely operate the surgical instruments attached to four robotic arms on a second console at the operating table.

Controlled by the surgeon at the console, the robotic arms do the cutting, clamping and cauterising with far greater flexibility and precision than is possible with human hands.

Unlike traditional surgery, da Vinci robotic-assisted procedures are minimally invasive. The instruments are inserted through small incisions.

“With this technology we can view the magnified organs, blood vessels and surrounding tissue in 3D, so that the surgery can be performed much more accurate,” said Dr Conradie.

During the surgery Dr Conradie used an ultrasound probe to determine the extent of the tumour, to make sure they remove all of it. It was an ‘angry red thing’, about 4cm long, on top of the kidney, which he successfully excised.

“It operation went extremely well,” Dr Conradie said afterwards.

Gouws is expected to be in high care for a day and will thereafter be transferred to a general ward for two days, after which she will be discharged from hospital. She will be back at work in about one week to ten days.

Gouws does not have children, only a “loving boyfriend”. She said Dr Conradie had told her having children should not be a problem, but that they should first do the procedure and then see what the outlook was.

Dr Conradie said the success rate of da Vinci procedures was much higher and recovery time much shorter compared to traditional surgery. The procedure itself was also faster.

 “I was devastated”

In another first, also on Thursday, urologist Dr Johan Venter who practises at Netcare Pretoria East Hospital performed his first nephrectomy, the complete removal of a kidney, on another patient also at Netcare Waterfall City Hospital. It was only the second nephrectomy done at a Netcare hospital with the da Vinci system.

“A complete success,” said Dr Venter after he removed 53-year-old Kevin Murphy’s right kidney, along with the fat and surrounding tissue in an operation lasting nearly three hours.

He used da Vinci technology to perform the procedure, but was unable to take the organ out through one of the small incisions made for the robotic arms, and had to make a larger incision for this purpose.

About two weeks ago Murphy noticed urine in his blood. After a visit to his doctor and some tests, the facilities manager was told he had a tumour in his kidney.

“I was devastated, I wasn’t in a happy space. I took it very hard at first,” Murphy said from his bed before the procedure on Thursday morning.

He said it was difficult coming to terms with having cancer and the realisation that he was going to lose part of his body.

“I am, however, very confident in Dr Venter’s ability and the advanced technology he’s using,” he said.

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How to rob a bank in the 21st century

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In the early 1980s, South Africans were gripped by tales of the most infamous bank robbery gangs the country had ever known: The Stander Gang. The gang would boldly walk into banks, brandishing weapons, demand cash and simply disappear. These days, a criminal doesn’t even have to be in the same country as the bank he or she intends to rob. Cyber criminals are quite capable of emptying bank accounts without even stepping out of their own homes.

As we become more and more aware of cybersecurity and the breaches that can occur, we’ve become more vigilant. Criminals, however, are still going to follow the money and even though security may be beefed up in many organisations, hackers are going to go for the weakest links. This makes it quintessential for consumers and enterprises to stay one step ahead of the game.

“Not only do these cyber bank criminals get away with the cash, they also end up damaging an organisation’s reputation and the integrity of its infrastructure,” says Indi Siriniwasa, Vice President of Trend Micro, Sub-Saharan Africa. “And sometimes, these breaches mean they get away with more than just cash – they can make off with data and personal information as well.”

Because the cyber criminals operate outside bricks and mortar, going for the cash register or robbing the customers is not where their misdeeds end. Bank employees – from the tellers to the CEO – are all fair game.

But how do they do it? Taking money out of an account is not the only way to steal money. Cyber criminals can zero in on the bank’s infrastructure, or hack into payment systems and even payment documents. Part of a successful operation for them may also include hacking into telecommunications to gain access to one-time pins or mobile networks.

“It’s not just about hacking,” says Siriniwasa.. “It’s also about the hackers trying to get an ‘inside man’ in the bank who could help them or even using a person’s personal details to get a new SIM so that they can have access to OTPs. Of course, they also use the tried and tested method of phishing which continues to be exceptionally effective – despite the education in the market to thwart it.”

The amounts of malware and available attacks to gain access to bank funds is strikingly vast and varies from using web injection script, social engineering and even targeting internal networks as well as points of sale systems. If there is an internet connection and a system you can be assured that there is a cybercriminal trying to crack it. The impact on the bank itself is also massive, with reputations left in tatters and customers moving their business elsewhere.

“We see that cyber criminals use multi-faceted attacks,” says Siriniwasa. “This means that we need to come at security from multiple angles as well. Every single layer of an organisation’s online perimeter need to be secured. Threat isolation is exceptionally important and having security with intrusion protection is vital. Again, vigilance on the part of staff and customers also goes a long way to preventing attacks. These criminals might not carry guns like Andre Stander and his gang, but they are just as dangerous – in fact – probably more so.”

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Beaten by big data? AI is the answer

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by ZAKES SOCIKWA, cloud big data and analytics lead at Oracle

In 2019, it’sestimated we’ll generate more data than we did in the previous 5,000 years. Data is fast becoming the most valuable asset of any modern organisation, and while most have access to their internal data, they continue to experience challenges in deriving maximum value through being able to effectively monetise the information that they hold.

The foundation of any analytics or Business Intelligence (BI) reporting capability is an efficient data collection system that ensures events/transactions are properly recorded, captured, processed and stored. Some of this information on its own might not provide any valuable insights, but if it is analysed together with other sources might yield interesting patterns.

Big data opens up possibilities of enhancing internal sources with unstructured data and information from Internet of Things (IoT) devices. Furthermore, as we move to a digital age, more businesses are implementing customer experience solutions and there is a growing need for them to improve their service and personalise customer engagements.

The digital behaviour of customers, such as social media postings and the networks or platforms they engage with, further provides valuable information for data collection. Information gathering methods are being expanded to accommodate all types and formats of data, including images, videos, and more.

In the past, BI and Data Mining were left to highly technical and analytical individuals, but the introduction of data visualisation tools is democratising the analytics world. However, business users and report consumers often do not have a clear understanding of what they need or what is possible.

AI now embedded into day to day applications

To this end, artificial intelligence (AI) is finishing what business intelligence started. By gathering, contextualising, understanding, and acting on huge quantities of data, AI has given rise to a new breed of applications – one that’s continuously improving and adapting to the conditions around it. The more data that is available for the analysis, the better is the quality of the outcomes or predictions.

In addition, AI changes the productivity equation for many jobs by automating activities and adapting current jobs to solve more complex and time-consuming problems, from recruiters being able to source better candidates faster to financial analysts eliminating manual error-prone reporting.

This type of automation will not replace all jobs but will invent new ones. This enables businesses to reduce the time to complete tasks and the costs of maintenance, and will lead to the creation of higher-value jobs and new engagement models. Oracle predicts that by 2025, the productivity gains delivered by AI, emerging technologies, and augmented experiences could double compared to today’s operations.

According to the IDC, worldwide revenues for big data and business analytics (BDA) solutions was expected to total $166 billion in 2018, and forecast to reach $260 billion in 2022, with a compound annual growth rate of 11.9% over the 2017-2022 forecast period. It adds that two of the fastest growing BDA technology categories will be Cognitive/AI Software Platforms (36.5% CAGR) and Non-relational Analytic Data Stores (30.3% CAGR)¹.

Informed decisions, now and in the future

As new layers of technology are introduced and more complex data sources are added to the ecosystem, the need for a tightly integrated technology stack becomes a challenge. It is advisable to choose your technology components very carefully and always have the end state in mind.

More development on emerging technologies such as blockchain, AI, IoT, virtual reality and others will probably be available on cloud first before coming on premise. For those organisations that are adopting public cloud, there are opportunities to consume the benefits of public cloud and drive down costs of doing business.

While the introduction of public cloud is posing a challenge on data sovereignty and other regulations, technology providers such as Oracle have developed a ‘Cloud at Customer’ model that provides the full benefits of public cloud – but located on premise, within an organisation’s own data centre.

The best organisations will innovate and optimise faster than the rest. Best decisions must be made around choice of technology, business processes, integration and architectures that are fit for business. In the information marketplace, speed and informed decision making will be key differentiators amongst competitors.

¹ IDC Press Release, Revenues for Big Data and Business Analytics Solutions Forecast to Reach $260 Billion in 2022, Led by the Banking and Manufacturing Industries, According to IDC, 15 August 2018

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