A quarter of a century ago, when I started my surgical residency training, surgical technology was in its infancy, at least in our part of the world. At the government (public) hospital where I worked, the only equipment that required electricity were the overhead operating lights. If a senior surgeon was performing a difficult operation, a suction machine, or sometimes the awe-inspiring electrocautery would be wheeled in. Otherwise, all surgeries were simply performed using various stainless steel forceps, scalpels, scissors and retractors (each instrument tongue-twistingly named after its surgeon-inventor – the Babcock forceps, the Mayo scissors, and so on), along with surgical mops and linen or catgut sutures (which were often threaded manually onto needles).
Towards the end of my general surgical residency, laparoscopy was introduced in my hospital – an amazing technological marvel for us. Later, during surgical oncology training, we started using surgical staplers and energy devices for cutting, sealing and joining tissues and organs. Over the last decade and a half, I have witnessed a phenomenal increase in the usage of technology and gadgetry in operating rooms. And woe betide the surgeon who does not keep himself/herself updated!
Recently, I was about to sit down at the robotic console to begin a rectal cancer surgery. When I glanced at my patient, it struck me how much technology was being used in that operation. I couldn’t help pausing to take a picture of my colleague Dr Hemanth, at the patient’s side, surrounded by technological wizardry. How mind-boggling this picture would be to my own self twenty-five years ago!
But, just as many things change, many things also remain the same. The time-honored surgical principles of “asepsis, hemostasis and gentle handling of tissues” are as much true today as they were over a century ago.
As the picture also shows, the human surgeon is still at the center of all technology. The surgeon who speaks with the cancer survivor and their family, the surgeon who gives hope, the surgeon who strives to do his/her best for the patient, come what may. Always the heart comes first, the mind next, only then follow tools and technology.