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Back To the Future of Surgery

Many of our members who follow along on the CBS social media accounts will have seen our repost of an Armistice Day Twitter thread by the Plastic Reconstructive and Aesthetic Surgery Insurance Scheme (PRASIS).

The PRASIS thread brilliantly synopsised the conditions during WWI that eventually led the work of Sir Harold Gillies and his teams to persuade those in power of the desperate need to provide specialised treatment for soldiers and civilians with facial wounds that were severe, life-limiting and, without innovative surgical interventions, potentially mortal. This story is widely known by those within the surgical community, but it nevertheless continues to inspire – even for those working outside of the medical community. 

The 20th Century saw major advancements in surgery - new technologies, techniques and treatments that made surgery safer, and meant better outcomes for patients with previously untreatable conditions. The revolutionary discovery of antibiotics cannot be understated, but, the 20th Century saw incredible advancements - including the first gender-affirming surgeries; huge changes with the advent of joint replacement as well as great strides in transplant surgeries and their outcomes. There were also major technological breakthroughs such as laproscopic techniques, IVF, and the first iterations of robotic surgeries.

UK Surgery in the 21st Century sees us routinely performing what surgeons 100 years ago might have considered ‘miraculous’ or ‘science fiction’ - for example, regularly using robot-assisted surgery and minimal incisions to treat patients; being able to restore mobility with nerve transfers; restoring Quality of Life to those afflicted by disease or injury; better, more reliable treatment outcomes and longer lives for many transplant patients; and even combining technological and engineering advancements with transplantation in bionic reconstructions. Those pioneering surgeons of the past would no doubt marvel at how far we’ve come – which naturally causes us to consider the vast possibilities ahead.

This month, the Confederation of British Surgery was proud to play a role in supporting the first in-person Future Surgery Show, which brought together thousands of surgeons, anaesthetists, and members of the perioperative team at the ExCeL Centre in London. The fascinating programme featured over 150 world renowned experts and an incredible array of topics, including global health innovation, patient-centred care, connectivity, disruptive technoloxgy, training and research.

Whilst the highly-anticipated event drew record numbers of in-person attendees, it was also available virtually to those unable to attend in person, making it accessible to many whose duties could not accommodate the travel to London. Alongside five dedicated educational theatres, the show also hosted the ASiT Innovation Summit, as well as the Association for British HealthTech Industries (ABHI) Surgical Simulation Theatre of the Future, where audiences were able to view Consultant Urological Surgeon Mr Ben Challacombe performed the first live robotic partial nephrectomy from Guy’s and St Thomas’s Hospital, in a livestream.  

Despite the thrill of finally being back together for in-person events, the realities facing Surgeons and patients were ever-present – not least in a panel discussion focusing on the impact of COVID on the future of elective NHS services citing the barriers, and promoting possible solutions. Additionally, double Paralympic Champion in British cycling Ben Watson spoke about parallels between elite athletes and surgeons - including the considerable risks of overtraining, as well as managing mental health conditions and burnout.

The programme was further supported by the surgical Royal Colleges of England, Edinburgh, Ireland & Glasgow, ASiT, The Association for Perioperative Practice (AfPP), the NHS Benchmarking Network, British Orthopaedic Association, College of Operating Department Practitioners (CODP), The Royal College of Nursing, The Royal Society of Medicine, and the Society of Surgical Simulation.

Whilst there is still much work ahead as we navigate the backlog and myriad other issues affecting both Surgeons and patients; and the nation continues to cope with new variants of COVID-19, we do consider it important and valuable to reflect on how much Surgeons have achieved already, and how far we can go.

Despite the obstacles of ‘the new normal,’ one thing is certain – Surgeons’ abilities to respond to novel challenges with a pioneering spirit of innovation should never be underestimated.  



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