History can play tricks in our minds. Sometimes what we think is revolutionary happens right before our eyes. But the truth is that it is the result of a series of small events and steps that gradually evolve over several years. There really is no overnight success.
You might disagree and point out that 1989-1990 marked the end of traditional open surgery. There is really no scientific evidence to support or substantiate the change from open to laparoscopy Cholecystectomy, The change did happen almost overnight. Patients are demanding this less invasive surgical option, medical device companies are sending surgeons to training workshops, and procedures that were previously easy and quick are suddenly very difficult and tedious.
But the reality is that the switch didn’t flip. There was no revolution.The road to a new era of surgery dates back to the 19th centuryth century.heard about it Swedish surgeon Hans Christian Jacobaeus Who coined the term “laparoscopy” and started his animal experiments in 1901? Does Heinz Kalk ring the bell? He was a German gastroenterologist who developed a high-quality laparoscope with improved lenses and the first front sight, earning him the title “Father of Modern Laparoscopy” in 1929. Did you know that laparoscopy was even banned in some countries in the mid-1950s and early 1960s? (Side note: If you like medical history as much as I do, look at this Excellent surgical history. )
Much of the slow evolution has to do with the limitations of technology. Another part is the belief that “big problems need big incisions,” which is deeply ingrained among surgeons. To create change, technical and emotional barriers must be overcome.Back in the 1970s, German gynecologists Kurt Karl Stephen Syme The use of laparoscopy to diagnose and perform gynecological procedures, such as oophorectomy, began, and progressed to the first laparoscopic appendectomy in 1980. His method was initially heavily criticized, but by 1984 another German surgeon, Erich Mühe, had created his own surgical laparoscope, and eventually performed the first laparoscopic cholecystectomy in 1985.
In 1988, laparoscopic cholecystectomy was adopted by a small number of U.S. surgeons who began to train others interested in the procedure. By the early 1990s, as minimally invasive surgery became more popular and popular, the demand for laparoscopy skyrocketed, and new instruments were being developed. It is worth noting that in September 1992, JAMA The article declares that laparoscopic cholecystectomy is the “gold standard” for the treatment of cholelithiasis. Nearly a century later, laparoscopy has finally been legitimized by the surgical community.
Two decades after laparoscopy became mainstream, robotic surgery emerged and introduced new technologies such as robotic control and 3D visualization, enabling traditional open surgery in urology and gynecology to be performed in a minimally invasive manner. Today, robotic surgery is performed in less than 5% of surgeries. It took another nearly 20 years before digital laparoscopy introduced any new material technological advancements. By shifting the focus of technology to digitizing the interface between the surgeon and the patient, surgeons have increased levels of control, safety, and comfort during laparoscopic procedures.
However, if you ask most surgeons today what their biggest frustration is, they’ll say their iPhone is more powerful and smarter than the OR. Surgeons still lack the technology and real-time clinical data to improve decision-making, which is critical in the high-pressure, highly variable conditions that occur repeatedly during any procedure. This is what really drives the outcome of the surgery.
You might be surprised to learn that one in five patients undergoing surgery today has one or more complications. This can lead to increased hospital stays, repeat surgeries, additional medical treatment, legal issues and increased costs. Many people with different skills, experience and training levels are also undergoing surgery. Therefore, it is challenging to achieve consistent results.
Dr. Mike Kelly Jr., former president of the Society for Laparoscopic Surgery, said:Successful change requires timing and greater power than the status quo. The most powerful force for sustainable change is a worthy goal. “
Clearly, the evolution of surgery is still a work in progress. But for what purpose? Surgeons and hospitals are committed to delivering the best possible outcomes for their patients – every time. It’s a worthy goal: to consistently deliver superior patient outcomes regardless of the surgeon’s skill, training, or location.
So, how can we turn the vision of consistently superior results into reality?From history, we knowEverything has to be put in place for change to happen. Often, technology is the missing link, but we are actively developing those missing pieces of the puzzle. We are building the foundation of digital laparoscopy and adding machine vision, augmented intelligence and deep learning capabilities to help guide improved decision-making, enrich collaboration and enhance predictability for all surgeons to translate the promise of consistent surgical excellence for practice. We call it performance-guided surgery.
There are other factors plaguing the healthcare industry that add to the urgency of pursuing the worthy goal of performance-directed surgery:
- Value-based care is shifting greater responsibility for poor quality and inefficiency to hospitals and physicians.
- Covid-19 has exposed the alarming financial fragility and capacity and resource constraints of hospital systems that must be strengthened and innovations accelerated.
- The patient’s condition has become more complex, and the treatment has become more complex. The absolute number of patients seeking care is increasing, with more patients suffering from multiple chronic diseases than a decade ago.
One thing’s for sure: Surgery won’t stay the same. As was the case in the 1900s, technology will catch up with imagination, and the development of surgery will continue. Ultimately, it’s up to the surgical community to decide how to help them perform better, more consistent procedures in the future.
We are entering an exciting new season of surgical development and look forward to partnering with those who share our curiosity and ability to invent a better way to operate.
About the author:
As President and CEO of Asensus, Anthony Fernando sets the company’s overall strategic vision and oversees its organic growth. Prior to his current role, he was Chief Operating Officer and Chief Technology Officer at Asensus, where he led the company’s technology strategy and global business operations.
Prior to joining Asensus, he was Vice President of Innovation and Technology at Stryker Corporation International, responsible for Stryker’s medical device portfolio. Prior to joining Stryker, Anthony worked at Becton Dickinson & Company as Director of Greater Asia R&D Facilities and Global Health; PerkinElmer Inc. as Asia R&D Director and Head of CoE; Varian, Inc. as Operations Director/General Manager of the Pharmaceutical Products Business Unit .
Anthony has an MBA from the Kenan-Flagler School of Business at the University of North Carolina at Chapel Hill, and an MS and BS in Mechanical Engineering, majoring in robotics and automation, from the University of Nevada, Las Vegas.
Photo: Movement, Getty Images
