Past and future of surgeries

The main careful advances of the most recent 20 years, and some old surgeries that are as yet well known.

LaparoscopyOriginally developed at the turn of the 20th century, it wasn’t until the 1980s that this technique really began to take off. Laparoscopy involves very small instruments inserted into a tiny hole, so the entire surgery can be performed without cutting open the patient. “It has rapidly transformed the way we think of surgeries in a lot of different contexts. It reduces recovery time, pain, and scarring,” says Matthews.

Endovascular SurgerySimilar to laparoscopy in that it is minimally invasive, endovascular surgery takes advantage of the body’s natural highway: the circulatory system. Doctors thread a catheter through major arteries, follow the progress of the line with real-time X-rays, and then deploy stents or coils to relieve aneurysms. “This gives us a new way to go after the problem,” says Matthews. “It allows us to avoid a big operation. Particularly, it allows the patient to avoid going on a heart/lung machine. And it also spurred, and continues to spur, the development of new biocompatible and drug-releasing materials.”

Like something out of science fiction, the ’00s saw the development and advancement of doctors using robots to perform complex surgeries. This even enabled telesurgeries, like a 2001 procedure where doctors in New York City remotely operated a surgical robot in France to remove a woman’s gall bladder. “It has revolutionized prostate surgery. It’s disruptive: this will start a whole new paradigm,” says Matthews, although he cautioned that the price of the machines ($1.5 million for the most advanced robotic surgeons) brings up questions about the cost/benefit ratio of such procedures.

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