The SARS-COVID-2019 pandemic of 2020 severely weakened the surgical innovation pipeline and ecosystem, primarily due to factors that include lack of a coordinated federal response, weakened health insurance coverage, a politicized approach to public health and safety, and disruption of the US economy. A successful bench to bedside innovation requires trust in the scientific research, open research and clinical facilities, and participation of patients in clinical studies. In addition, stay-at-home orders and the shutdown of elective medical and surgical care and research laboratories diminished opportunities for the informal interactions that are part of the new product development process. The pandemic and how it was managed prolonged the length of time for creation, adoption, and diffusion of new products and services into the market. Furthermore, the loss of hospital revenues from canceled elective care translates into a much smaller market for new technologies. Looking forward, critical success factors for innovation include federal policy that supports science and offers access and insurance coverage for health care, including addressing social determinants of health. Any further shutdowns of research and clinical care will hinder necessary collaborations between scientists, clinicians, and patients. Economic recovery is required to ensure federal and corporate funding for research and development. Trust in science must be restored to ensure support of necessary regulatory review processes and sufficient participation in clinical trials. Surgical discoveries have brought about lifesaving and life-extending cures, and the pipeline of these discoveries must continue without interruption.
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