Mr. Walter Eisner, Senior Reporter for Orthopedics This Week, plans to talk about what has been written by about spine over the last year. He is currently working on a feature about the last two hundred years of surgery and will quote Atul Gawande, M.D., M.P.H. (in his opinion, the best medical writer in America). Dr. Gawande wrote this for the current 200th Anniversary Issue of The New England Journal of Medicine. It totally speaks to what we are pioneering.

“Minimization of the invasiveness of surgical procedures is an advance that is arguably as significant as the discovery of anesthesia. In recent decades, the advent of laparoscopy and thoracoscopy reduced the debilitating, half-meter-long abdominal and chest incisions to a half centimeter. The subsequent introduction of endoscopic and percutaneous techniques has turned incisions into mere puncture wounds…The technological refinement of our abilities to manipulate the human body has been nothing short of miraculous.

The increased safety and ease of surgery have produced an explosion in the volume of operations being performed — to at least 50 million annually in the United States alone… This profound evolution has brought new societal concerns, including how to ensure the quality and appropriateness of the procedures performed, how to make certain that patients have access to needed surgical care nationally and internationally, and how to manage the immense costs. As early as the 1970s, researchers began documenting substantial rates of fatal errors in surgical care, wide differences in outcomes among institutions, and large disparities in access to care both within the United States and between countries. The science of effectively routinizing surgery for mass populations is still in its infancy, as it is for all areas of medicine.

Meanwhile, the practice of surgery itself will continue to change. Prognostication is a hazardous enterprise. But if the past quarter century has brought minimally invasive procedures, the next may bring the elimination of invasion. One feels foolish using terms like nanotechnology but scientists are already experimenting with techniques for combining noninvasive ways of seeing into the body through the manipulation of small-scale devices that can be injected or swallowed. Surgical work will probably even become fully automated.

The possibilities are tantalizing. A century into the future, a surgeon will tell the tale — that is, if the world still makes such people.”

Read Full Feature Article for the 200th Anniversary Issue: Two Hundred Years of Surgery – Atul Gawande, M.D., M.P.H. – New England Journal of Medicine
Read Walter Eisner’s Article: Intradiscal Society at Crossroads – Walter Eisner – Orthopedics This Week (Download PDF)

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