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Foreword
Theadventoflaparoscopicsurgerywasarevolutioninsurgery,whichcontrasted
withthemanyincrementalimprovementsthathavecharacterizedmostprogress
insurgery(andscience).Thiswasconsideredasignifcantparadigmshiftand
acompletelynewwayofdoingsurgery.Buttherewasoppositionbytheappro-
priatelyconservativesurgicalfraternity.Itwasheardthat(bigmistakesandmade
throughsmallholes’and(whywouldyoulookthroughakeyholewhenyoucan
justwalkthroughthedoor’.Aftertwotothreedecades,laparoscopicsurgery
isestablishedandwon’tgoaway.Thechallengeiscontinueimprovingthetech-
nologyandthepatientoutcomes.
Theoriginoftherevolutionwasverysimple.Combiningavideocamerawith
alaparoscopeallowedthesurgeontoworkwithtwohands,byhandingthe
scopeofftoanassistant.Italsoallowedothersintheroomtosharethesurgeons
view,asassistantsandlearners.ArthurKoestlerisquotedassayingthat(the
moreoriginalthediscovery,themoreobviousitisafterwards’.
Laparoscopicsurgerycaughtthepublic’simagination.Patientswerehappytobe
toldoftheobviouscosmeticandconvalescentbenefts.Somesurgeonsgrabbed
themarketingopportunityandpromotedlaparoscopicsurgery,oftenwellbe-
forecomparativeevidencewasavailableregardingsafetyandeffcacy.And
therewastalkofanewsurgicalspecialtybasedonatechnology,ratherthanan
organsystem.Sensehasprevailed,becauselaparoscopicsurgeryisnomorethan
(anothertoolinthetoolbox’andhasbecomeintegratedintotheexistingsurgi-
calspecialties.
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