The field of surgery is slowly undergoing a quiet revolution. Utilizing newer methods of pain control, understanding and reducing the perioperative stress response, and adapting minimally invasive operative techniques to many procedures have greatly improved patient outcomes with fewer complications, shorter hospital stays, and reduced convalescent recovery. Academic surgery is also undergoing profound changes, brought about by the financial shortfall constantly facing hospitals and the decreased reimbursement provided for professional services. Surgeons have responded to these pressures by increasing the number of operations they perform, thus devoting more time to service (e.g., patient care) and less time to the academic pursuit of research.

For many reasons, surgeons are decidedly qualified to carry out research. As a general rule, they have an extraordinary capacity for hard work and tend to be problem-focused and solution-oriented. Their technical skills provide them with the opportunity to access blood and tissues as well as to master complex bench techniques. Surgical patients are among the most challenging to care for, posing an almost endless number of hypotheses that can be tested through basic, clinical, and translational research. In spite of pressures to spend more time in the operating room, we believe that advances in the understanding of the pathophysiology and treatment of diseases will be improved if the surgical-scientist is a front line investigator.

Several years ago it became apparent that surgical science was being reemphasized, and several of us sought remedies to decelerate and reverse these changes. Acommittee of the American Surgical Association was formed to make recommendations, a biannual teaching conference (Young Surgical Investigators) and a Clinical Trials Methods Course were organized by the American College of Surgeons, and the annual program on Fundamentals of Surgical Research was initiated by the Association for Academic Surgery. In addition, the senior editors of this book reviewed the general field of surgical research and suggested approaches to evaluating output and to improving and quantitating productivity by applying research methodologies developed and utilized in industry.

Finally, we concluded that a reference source on surgical research would provide the foundation for this academic endeavor and would serve to prevent erosion of this important intellectual basis of our specialty. Not only would such a volume be a place for young investigators to start when initiating their research projects, but it would reflect the philosophy, history, evolution, and ethical basis of this broad field.

Initially, we were hesitant to propose such a project, but we were greatly encouraged by members of the editorial staff of Academic Press; our thanks go to Jasna Markovac and Graham Lees for their help in initiating and completing this project. We contacted five recognized research leaders who would subsequently serve as co-editors, and they enthusiastically supported the concept of codifying the basics of surgical research. We then wrote to over 100 surgical scientists, recognized experts in diverse fields, and asked them if they would be willing to contribute to this effort; the response was a unanimous yes!

This work is organized so that the material required for designing and starting a research project is found at the front of the book, the methods and techniques required to perform the investigation are found in the middle of the volume, and the skills needed for analyzing, writing, and presenting the material follow. Overviews of research efforts in surgical subspecialties are also included, followed by chapters on the history of surgical research, the integration of research into a clinical department, biographies of surgeons who have been awarded the Nobel Prize, and a précis on converting an idea to a product.

The scope of the text is quite broad, and we have made every effort for the reader to use this information as a spring- board to find new ideas and information by way of the Inter-net and traditional medical libraries. The text is also supported by a Web site (http:\\www.academicpress.com/surgery), which will continue to provide updated information on new methodology and techniques in a variety of fields. We hope that this method of communication will keep our readers updated and current and will enhance the exchange of information within the surgical community.

Surgeons are in the best position to improve surgical care. By evaluating our outcomes and addressing our clinical problems, surgeons can use scientific methodology to enhance recovery of the surgical patient. We hope that Surgical Research will serve in some small way to support this effort.