Surgery
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The world is spinning faster and faster and every day new technological advances are made. The field of surgery is no exception and procedures that seemed impossible only a few decades ago are considered as standard today.

I discussed breakthrough in surgical technology, what it is striving to achieve and what the future holds in store for us, with senior doctor Gorazd Košir, head of the department of cardiac surgery at the University Medical Centre Maribor. And I must say that some things he had told me made me feel like a wide eyed kid all over again.

WHAT ARE NEW TECHNOLOGIES STRIVING FOR?

“Modern surgery was not possible before the middle of the 19th century as there was no pain control through anesthesia; likewise modern cardiac surgery wasn’t possible before the second half of 20th century due to the lack of advanced technology,” was the brief history lesson I received at the beginning of our conversation.

But as we all know technological advance has skyrocketed in the last few decades and for many surgical procedures the question is no longer “Can we do it?”, but “What can we do to improve it?”.

According to Dr. Košir, there are currently three main goals technological trends in surgery are striving to achieve:

  • minimizing invasiveness of surgical procedures
  • simplifying the surgical procedure as much as possible and make it shorter for both the surgeon and the patient
  • eliminating and minimizing the human factor in those steps where it could lead to mistakes

“Due to the rapid development of surgical cameras, lasers and probes, we can now minimize invasiveness by making cuts that are just a few centimeters wide. For example, we don’t have to cut the whole sternum to perform a procedure in cardiac surgery. A few small cuts between the ribs are usually enough to insert the instruments and to operate on the heart from the outside. “

“In such cases, there are robots that help surgeons perform small, delicate movements of the instruments, while the camera zooms in on the details, which are hardly visible to the naked eye. A robot which transforms a 5 cm hand movement into a 5 mm instrument movement is not really a trend anymore, but a standard,” explains Dr. Košir.

“Furthermore, there are various inventions and improvements that are available for doctors on the daily basis. One of such is the Adora system. It enables the surgeon to get patients data without physically touching the computer. This saves time and lowers the chance of an infection. Such systems demonstrate that the technology surrounding us is constantly improving. This concept can also be used in the future.”

For what? You will find out a bit latter, as we are not in the future just yet.

IMPROVING LIVES WITH THE HELP OF ARTIFICIAL BODY PARTS

As Dr. Košir already has a long career in the field of cardiac surgery, I asked him about some of the inventions that he considers a breakthrough.

“One of the novelties that spring to mind are new artificial heart valves. With these new valves the patient doesn’t need to take anti-clotting medications. This is great for the patient as it removes all the unwanted side effects. In addition, in one third of the procedures in Germany, such valves are inserted through bigger blood vessels and then guided to the heart. There is practically no damage done to the body.”

Another novelty, which Dr. Košir mentions, is the invention and significant improvement of smaller heart pumps. When the patients’ heart starts to weaken there is an option to insert such a pump. This helps the heart with pumping blood or can entirely take over its function.

If artificial body parts were just a matter of imagination throughout the history, this is no longer the case. Today they can efficiently help patients to improve and prolong their lives.

AND THE FUTURE?

“What about the future?” I asked Dr. Košir. “Which improvements and new technologies are knocking on the door?”

The voice and motion command system that Adora uses could be also implemented with other equipment. For example, it could be used to adjust lights in an operating room with your voice, to mix and dose medications, as well as, in otorhinolaryngology and orthopedics for precise adjustment of smaller instruments. These are just some examples of where such a system could be used to save time, lower the possibility of infections and increase the quality of a procedure. But to do all that, it must function perfectly, of course.”

Improvements in robotics will also enable the intriguing possibility of long distance surgical procedures, says Dr. Košir.

Hand gesture based image navigation during surgery

Hand gesture based image navigation during surgery

“When improvements in robotics will allow it, a top surgeon will be able to control a robot in another hospital. Of course, a medical team will still be present in the operating room to make sure there are no complications, but the surgeon won’t have to actually travel there. It’s great for both the surgeon and the patient. It’s also very interesting from financial and organizational perspective.”

One more thing Dr. Košir mentions was the advance in the field of stem cells research.

“They are trying to grow artificial organs and tissues from stem cells. These substitutes would then be surgically inserted or would replace the original organ or tissue. These are the directions of future trends and technologies.”

ALL THAT GLITTERS IS NOT GOLD

These were the words Dr. Košir used when concluding our discussion. Not to be misunderstood, technology has come a long way. It allows new options in medicine and surgery we could have only dreamed of a few decades ago. But there is always the other side of a coin.

“All these improvements also pose a risk when combined with the modern way of life,” tells Dr. Košir.

“We live “instant lives” and everything around us moves faster. The medical field is not an exception. New technologies are quickly improved or replaced. Surgical procedures are done faster and while this should be a good thing, it also results in these procedures being less accurate and short lived. Because new methods are less invasive, the way of thinking quickly becomes: “We can do it again, if needed.” Of course, that depends on the surgeon, surgical field and other circumstances. However, it is a risk worth considering.”

Dr. Košir also noticed that current trends of living are having an impact on surgery in a very problematic way.

“Another problem is that less and less people are willing to become a surgeon these days. Being a surgeon makes studying a lifelong process and means that one has to be present in the hospital more or less the whole time. People don’t want this anymore. It’s also not a get-rich-quick kind of profession and modern ambitions are to have a job where you can earn a lot of money with doing little work. And this is not what a surgeon is.”

What do you think?

Will trends in medicine adapt to trends of modern life? If so, how will this affect the area of surgery?

Last but not least, I would really like to thank Dr. Košir for sharing his knowledge and opinion with us. It was a pleasure talking to him.

 

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