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Lasers, minimally invasive surgery, and general surgery: challenges and future directions

The face of surgery is changing rapidly since the advent of the laparoscopic cholecystectomy and the heightened interest in minimally invasive surgery. There is little question that the expansion of minimally invasive techniques and technology are driven by patients and industry. These factors are counter to the mainstream of general surgeons who remain reluctant to accept change despite declining numbers of general surgeons, an increasing trend toward sub-specialization and shrinking spectrum of diseases being treated. The enthusiasm for laser applications in general surgery is declining despite an ever-increasing array of wavelengths, increasingly complex and expensive technology and the availability of multiple delivery devices. The future of surgery holds several opportunities for the refinement of laser and minimally invasive surgical technologies and their application to routine problems. However, the challenge for the future must remain a balance between the availability of technology and cost containment. This paper examines the challenges and future directions for lasers and minimally invasive techniques in general surgery.