Surgical innovation and technology
British journal of surgery, vol. 113
Abstract
BACKGROUND: The pace of surgical innovation appears ever faster. Innovation is being freed from the design constraints of the opposable digits of a surgeon's hand through the use of programmable binary digits. Surgeons must be the drivers of change and central to the application of innovations. We should collaborate with industry, engineers and scientists to think out of the box but must consider also expense, environmental impact, equity, and ethics. But we should not be blinded by shiny technology: innovation without impact is mere noise. The ultimate considerations are the diagnosis and management of surgical disease, of improving the care of our patients. METHODS: Expert surgeons, scientists and engineers across the world were identified and invited to describe areas of innovation within surgery. They were given free rein to review their areas of expertise and to discuss both current and future applications of technology within surgical care. RESULTS: The Commission spans multiple surgical specialties and scientific domains. It reviews translational genomics, including the role of ctDNA, alongside microbiomic and proteomic applications in improving the diagnosis, treatment and monitoring of surgical disease. Applications to enhance surgical procedures are described, from medical micro/nanorobots for minimally invasive interventions, sensory-enriched surgery with visual optimization and molecular image-guidance to intelligent and semiautomated instruments. The expansion and broad influence of artificial intelligence in surgical writing, training and simulation, diagnosis and robotics is widely described. The role of surgical innovation and technology in driving personalized care for benign and malignant surgical disease from genomic profiling to bespoke surgical and non-surgical treatment pathways and surveillance is considered. CONCLUSION: The future of surgery is poised to become more precise, personalized, and effective. Collaboration with engineers, data scientists, and industry partners not only represents an exciting opportunity for surgeons to participate in team science but is critical to focus innovation goals on optimizing patient care and outcomes.
Authors 29
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University Medical Center Utrecht
Affiliation as printed
Department of Surgery, University Medical Centre Utrecht , Utrecht ,
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Peter G Vaughan-Shaw corresponding
Affiliation as printed
Academic Colorectal Unit, Western General Hospital , Edinburgh ,
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St. Vincent's University Hospital
Affiliation as printed
Department of Sugery, St Vincent’s University Hospital , Dublin ,
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Affiliation as printed
Department of Cancer and Genomic Sciences , University of Birmingham, Birmingham, UK
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Affiliation as printed
Department of Surgery and Cancer, Imperial College London , London ,
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Royal Free London NHS Foundation Trust · University College London
Affiliation as printed
Centre of Surgical Innovation , Organ Regeneration and Transplantation (CSIORT), Department of Surgery and Biotechnology, UCL, London
Royal Free London NHS Foundation Trust , London
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Centre National de la Recherche Scientifique · Inserm · Laboratoire des Sciences de l'Ingénieur, de l'Informatique et de l'Imagerie · Institut de Recherche contre les Cancers de l’Appareil Digestif · Hôpitaux Universitaires de Strasbourg · Institut de Chirurgie Guidée par l'Image · Université de Strasbourg
Affiliation as printed
Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg , Strasbourg ,
ICube, UMR 7357, CNRS, INSERM U1328 RODIN, University of Strasbourg , Strasbourg ,
IHU-Strasbourg, Institute of Image-Guided Surgery , Strasbourg ,
IRCAD, Research Institute Against Digestive Cancer , Strasbourg ,
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Chinese University of Hong Kong
Affiliation as printed
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong , Hong Kong SAR
Multi-Scale Medical Robotics Centre, Hong Kong Science Park , Hong Kong SAR
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Daphne D. D. Rietbergen Aachen Department of Radiology Section Nuclear Medicine Interventional Molecular Imaging Laboratory
Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Radiology, Section Nuclear Medicine, Leiden University Medical Centre , Leiden ,
Interventional Molecular Imaging Laboratory, Leiden University Medical Centre , Leiden ,
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Leiden University · Leiden University Medical Center
Affiliation as printed
Interventional Molecular Imaging Laboratory, Leiden University Medical Centre , Leiden ,
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University Medical Center Utrecht
Affiliation as printed
Department of Surgery, University Medical Centre Utrecht , Utrecht ,
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Portsmouth Hospitals NHS Trust · University of Portsmouth
Affiliation as printed
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust , Portsmouth ,
University of Portsmouth , Portsmouth ,
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Chinese University of Hong Kong
Affiliation as printed
Department of Biomedical Engineering, The Chinese University of Hong Kong , Hong Kong SAR
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Affiliation as printed
Department of Surgery and Cancer, Imperial College London , London ,
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Affiliation as printed
Department of Medical Physics and Biomedical Engineering Charles Bell House , UCL Hawkes Institute, University College London, London ,
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Portsmouth Hospitals NHS Trust
Affiliation as printed
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust , Portsmouth ,
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Affiliation as printed
Centre for Surgical Innovation, Organ Regeneration and Transplantation (CSIORT), Hampstead Campus, London
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Affiliation as printed
Department of Surgery and Cancer, Imperial College London , London ,
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Chinese University of Hong Kong
Affiliation as printed
Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong , Hong Kong SAR
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong , Hong Kong SAR
Multi-Scale Medical Robotics Centre, Hong Kong Science Park , Hong Kong SAR
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Chinese University of Hong Kong
Affiliation as printed
Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong , Hong Kong SAR
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong , Hong Kong SAR
Department of Surgery, The Chinese University of Hong Kong , Hong Kong SAR
Multi-Scale Medical Robotics Centre, Hong Kong Science Park , Hong Kong SAR
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Northwick Park Hospital · Wellcome / EPSRC Centre for Interventional and Surgical Sciences · St Mark's Hospital · University College London
Affiliation as printed
The Griffin Institute, Northwick Park and St Mark’s Hospital ,
Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London , London ,
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Affiliation as printed
Department of Medical Physics and Biomedical Engineering Charles Bell House , UCL Hawkes Institute, University College London, London ,
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Leiden University · Leiden University Medical Center
Affiliation as printed
Interventional Molecular Imaging Laboratory, Leiden University Medical Centre , Leiden ,
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Northwick Park Hospital · St Mark's Hospital
Affiliation as printed
The Griffin Institute, Northwick Park and St Mark’s Hospital ,
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Affiliation as printed
Department of Cancer and Genomic Sciences, University of Birmingham
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Chinese University of Hong Kong
Affiliation as printed
Department of Surgery, The Chinese University of Hong Kong , Hong Kong SAR
Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong , Hong Kong SAR
Multi-Scale Medical Robotics Centre, Hong Kong Science Park , Hong Kong SAR
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Portsmouth Hospitals NHS Trust
Affiliation as printed
Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust , Portsmouth ,
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Affiliation as printed
Department of Surgery and Cancer, Imperial College London , London ,
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Affiliation as printed
Academic Colorectal Unit, Western General Hospital , Edinburgh ,
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