title: Innovations in Endosurgery-Journey into the Past of the Future: To Ride the SILS Bandwagon or Not?
abstract: Progress in surgical practice has paralleled the civilizational evolution. Surgery has progressed from being the last resort in saving life to being form and function preserver. Post-renaissance Industrial age gave an impetus to this march of surgery. The currently on going digital technological revolution has further catalysed this march. Having achieved the stabilized and acceptable clinical outcomes, the surgeon has embarked on a journey of improving patient reported outcomes (PRO). Improvement in PROs with the advent of laparoscopic surgery with the attendant emphasis on minimising invasion has led to debates about invasion being just parietal or holistic in physiological sense. There is a concern that parietal invasiveness shouldn't be a trade-off for compromised clinical outcomes. Single Incision Laparoscopic Surgery (SILS) in its current avatar with current instrumentation seems to be an enthusiastic bandwagon rolling on with the cosmetic benefits acting as veil to hide the potential clinical concerns. History of surgical innovations is riddled with tales of vindictiveness and vicissitude. Lest the same fate befalls SILS we would do better to examine the SILS bandwagon in its current form till the emerging technologies address the current concerns.
authors.affiliation: Department of General Surgery, Sir Ganga Ram Hospital, New Delhi, 110060 India ; Dr. Agarwal's Surgery & Yoga, F-81&F-82, Street 4, Virender Nagar, Janakpuri, New Delhi, India.
authors.forename: Brij B
authors.initials: BB
authors.lastname: Agarwal
authors.lastname: Chintamani
authors.forename: Kamran
authors.initials: K
authors.lastname: Ali
authors.forename: Karan
authors.initials: K
authors.lastname: Goyal
authors.forename: Krishan C
authors.initials: KC
authors.lastname: Mahajan
keywords: History of innovations; Informed consent; Innovations in surgery; Metric of innovation; Patient reported outcomes; Reduced port surgery; Single incision laparoscopic surgery (SILS)