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Doody's Review ServiceReviewer: David J. Dries, MD (University of Minnesota Medical School)
Description: This is a historical review and proposal for systematic introduction of advanced surgical techniques.
Purpose: Motivated by recent litigation surrounding technical innovation in surgery, the editors prepared this monograph to improve understanding of problems which arise with surgical innovation and the regulatory concerns which they prompt. Included are multi-institution discussion and data collection with a survey of U.S. surgeons published in original form by the Journal of the American College of Surgeons.
Audience: Surgical leaders, surgical practice administrators, trainees and practitioners of surgery, and members of research review committees (Institutional Review Boards) are an appropriate audience for this work produced by a group of surgical leaders, medical ethicists and law school faculty from the U.S.
Features: After reviewing some of the history surrounding the introduction of anesthesia and modern surgical procedures, the editors include monographs describing the present state of surgical innovation, limits of present assessment for evolving surgical technique, and attitudes of surgeons in the U.S. on this subject. Given the background assembled from clinical, legal, and ethical sources, a framework is proposed for a systematic introduction of new surgical methodology. Though multiple disciplines are represented by the authors, a consistent writing style is used and each chapter cites clinical references, websites, ethics, and casework to develop the concluding proposal.
Assessment: This thoughtful review describes the state of surgical practice, offering a framework for utilization of collected clinical observations which give way to clinical reports and ultimately high-level, formal, prospective trials.