Incisions

Surgical intervention is sometimes the sole way to relieve impairments and lower the risk of mortality from common diseases. Surgical interventions account for an estimated 13% of the world’s total disability-adjusted life years, with millions of individuals undergoing treatment each year. While surgical operations are meant to save lives, poor surgical care can result in serious consequences, given the prevalence of surgery.

It is important to understand the progress of surgery in modern times, especially as the American College of Surgeons prepares to hold its 100th annual conference in San Francisco. Surgeons were represented as having masculine type A personalities some decades ago, which remains unchanged, and a few surgeons have been termed as spoiled brats of the hospital. Surgeons were regarded and respected, and their autonomy and power were assumed. Patients almost never questioned the treatment plan.

With strong dyadic mentor-mentee interactions, the training model was pyramidal. The approach to surgical education was “see one, do one, teach one.” Being there to personally manage situations in the hospital and being ‘on call’ every other night provided the requisite experience.

The majority of operations were open surgical procedures performed in the main operating room, with surgeons frequently manning multiple rooms. Surgical patients usually had to stay in the hospital for a long time before fully recovering. Inpatient services were often substantial, with 50 to 60 patients under each service. The practice of surgery has changed dramatically during the last several decades. With the entry of more women and minorities into the surgical specialty, the field is becoming more diversified.

The surgical techniques have been transformed from ‘open’ to laparoscopic or keyhole surgery to robotic-assisted surgeries. The next decade may see an autonomous robot doing basic surgeries with precision and uniform results, while human intervention may only be required in a handful of the more complex cases.

As I write this, millions of dollars are spent on machine learning and AI, which have the potential to transform the landscape of surgery. Despite the fact that some surgeons believe they are not as respected by the general community as they once were, many have improved their work-life balance.