A future in which surgeons will be able to use technology to operate on parts of the body where their view is obscured by tissue – rather like pilots flying through bad weather – is forecast in an editorial in the Journal of the American Medical Association.
Mark A. Talamini and Eric J. Hanly of Johns Hopkins University School of Medicine, Baltimore, write: “Augmented reality surgery in which pre-operative and real time image data (eg computed tomography, ultrasonography) are overlaid on the surgeon’s view of the operative field, is an area of active development.
“With such technology one can easily imagine how surgeons will soon be able to operate where their view is obscured by tissue, just as the modern pilot can take off, land and fly through bad weather using radar and infra-red picture substitution.”
The article, which reviews technology trends in the operating suite, also points to “an era of telesurgery” in which the surgeon works remotely from the patient. The technique has been used for a widely-publicised transatlantic gall bladder removal, but Talamini and Hanly also record its use for laparoscopic procedures in medically-underserved and remote parts of Canada.
“While a number of legal, economic and social factors currently prevent pervasive adoption of routine telesurgery, it is clear that telemedicine and the invasion of technology into the operating room will have a significant impact on the practice of surgery – even with respect to aspects of medicine as fundamental as the patient-physician relationship,” Talamini and Hanly conclude.
Other future technologies identified are the use of computer technology to allow more precise suturing of the beating heart and intra-abdominal surgery performed via the mouth with no external incisions on the patient’s body.
The authors caution, however, that such advances are very expensive and highlight the need to identify those that are truly better for patients and others that are simply enticing.
“Who will pay for studies to distinguish between these? Are those technology-based procedures that appear to be better truly cost effective? Are there sufficient safeguards in place?” they ask.