Emerging new technology: Are surgeons leading or being led?

摘要

The modern operating room is the repository of new monitors, pumps, transport devices, and lighting systems, however, up until the last 15 years or so, it could be cogently argued that surgeons from the beginning of the 20th century might not be unduly uncomfortable in the operating rooms of the 1990s. The recent explosion of surgical devices and novel technologies with its scopes, staplers, ports, and robots has changed this paradigm. Surgery has transformed from a personal technique-driven activity into a device- or technology-driven profession seemingly only restricted by fiscally driven access. The concept of so-called "disruptive" technologies has been popularized as a feature of societal change but not of surgical advancement. These technologies are inexpensive, simple, and rely on less skilled personnel. Examples of such disruptive technologies in society include the introduction of photography or the printing press which replaced more complex systems, requiring lesser technical skills necessary for their widespread dissemination. By contrast, surgery is now increasingly reliant upon more specialized personnel and the outlay of high capital expenditure with regionally limited access using highly sophisticated technologies. Consequently there is a greater public expectation of the delivery of more complicated health care [1],