Exploring surgical trends in the operating theatre

Advances made in surgery over the last decades have offered significant patient benefits including enhanced quality, reduced invasiveness and decreased post-operative pain for their recovery. The innovations look set to continue with developments including increased use of robots, artificial intelligence (AI), augmented and virtual reality, and three-dimensional printing (3D). There are a number of challenges associated with implementing new approaches to surgery, not least training and governance. Patients increasingly need to have full disclosure of the innovations, and the surgeon who will perform the surgery needs to ensure that informed consent is obtained with transparency. Surgical teams need to stay up to date with the latest techniques, technologies and patient safety protocols.

New technologies can include new techniques, modified procedures or new devices to achieve the desired outcome — such as in the case of minimally invasive approaches to abdominal surgery, which have revolutionised the specialism over the past 30 years. Evidence-based practice and increased governance protocols have fundamentally changed the way that innovation in surgery has to take place. The Royal College of Surgeons (England)¹ has led the way in identifying steps for safe implementation of new technologies and the Medical Research Council² has published guidance on the development and evaluation of complex intervention research. The pace of innovation in many aspects of modern medicine is continuing exponentially, so it is to be expected that all health professionals will be involved at some time. Structured and well-designed training programmes are needed to ensure the safe implementation and dissemination of novel technology.

It is surprising that the first laparoscopic cholecystectomy was undertaken only in 1985 and began a huge change in surgery. The main advantages were the small incisions, reduction in surgical site infections, early discharge from hospital and less postoperative pain for the patient. This innovation in surgery has been described as a paradigm shift in surgical practice. MIS techniques have small incisions, specialised instruments and advanced imaging technologies enabling the surgeon to work in small and often difficult to access areas. Since the first laparoscopic intervention, the technique has been used in many different procedures, each tailored to different anatomical sites and medical conditions. Patients undergoing laparoscopic surgery experience less blood loss, lower opportunity for surgical site infection and improved cosmetic outcomes. The approach results in less trauma to surrounding tissues, leading to decreased postoperative complications.