Special issue on surgical innovation: new surgical devices, techniques, and progress in surgical training.

The aims of surgical innovation include minimal tissue trauma, short operation times with brief ischemia periods, minimal blood loss, steep learning curves, and preferably no complications. The common goal of all of these factors is to improve patient outcomes. Innovations such as intramedullary nailing, established by Gerhard Küntscher in 1940; the heart-lung machine, established by John Gibbon in 1953; and laparoscopic surgery, developed by Kurt Semm in the 1980s have revolutionized the surgical field in the last century.

While surgeons must permanently adapt to this progress, they still must preserve core surgical techniques such as surgical hand ties or suturing techniques. This becomes particularly important when complications such as bleeding occur or when newer techniques fail.

The working hours for physicians and surgeons have decreased over the last few decades, but the administrative workload and amount of medical knowledge that must be learned have continued to increase. Because the numbers of clinical duties have grown more rapidly for surgeons than for other medical disciplines, and because hospitals increasingly depend on the income generated by surgeons, it is not surprising that surgeon-driven grants have decreased over time, fewer surgeons pursue careers in basic and translational research, and less research output (e.g., research publications, patents) arises from surgical fields.[1] Thus, the current health care environment has made the career path of a surgeon-scientist prohibitively challenging.

Despite this trend, research focusing on surgical innovation should continue to be executed and promoted. New instruments, technologies, minimally invasive approaches, and surgical simulations need to be incorporated in current surgical practice with the goal to further minimize patient harm during surgical procedures. Surgeons are at the forefront of surgical disease and might know best the limitations of current surgical treatments.

The present special issue focuses on innovation and discoveries in surgical science, and its goal is to offer surgeons and other physicians the opportunity to publish their research in surgical innovation.