Surgery

Technological advances in robotics and imaging devices suggest dramatic changes in the operating room of the future. Robots have already performed certain procedures in clinical trials. One such trial involves using a robot in surgery to help replace non-functioning hips with a prosthesis. Hip-replacement procedures are commonly performed and have a high rate of success. But surgeons have long been concerned about the procedures that do not succeed due, in part, to the difficulty of creating an exact fit for the prosthesis.

Developers of the robot used in the clinical trials hope the robot will be able to do a better job. The robot is linked to a CT scanner which measures the exact dimensions of the thigh bone. These measurements are used to help the robot hollow out a cavity in the thigh bone which will be an exact fit for the prosthesis. Successful use of such robots could change the role of the surgeon, whose tasks may include robot supervision in the future.

New imaging devices should also help surgeons operate more safely and efficiently in the future. Researchers are currently working on imaging devices that combine powerful computer technology with existing imaging technology to produce images of the body during surgery. Such images could be used for surgeons in training, to see how the body changes during surgery. They may also be used during surgery to limit the amount of potentially harmful cutting that is done. As technology enables surgeons to be more precise about where they cut, surgery could become more effective and less invasive.

One possible result of this could be what has been dubbed "trackless" surgery, procedures performed without cutting the patient. If images of harmful tissue, such as a breast tumor, could be sharpened, surgeons may be able to operate by simply focusing ultrasound waves on the tissue. Mastery of such techniques could make scalpels, sutures, and other conventional surgical tools obsolete.

Surgery of the future may bear little resemblance to the bloody, messy surgery of the present. But certain elements of surgery are unlikely to change. Surgical innovation will continue to require patients willing to take a risk and surgeons willing to challenge convention. Surgical skill will continue to require the traits Hippocrates urged surgeons to honor in ancient Greece: "ability, grace, speed, painlessness, elegance, and readiness." Finally, surgical progress will continue to depend on the ability of skilled surgeons to use their physical ability and their medical knowledge to heal patients.