Patient safety and surgical innovation–complementary or mutually exclusive?

Safety vs. innovation Safety and innovation are not and need not be antagonists, but synonyms. If innovation is driven by safety, we can hopefully accelerate the rate of innovation desperately needed in medicine. In the surgical microcosm, it is not infrequent to hear the voices of surgical conservatism question innovation: why change the current device or method? It is proven to work, it is vetted by years of clinical research, and should therefore be chosen–because it’s safer. There’s nothing wrong with that thought process, is there? There is no doubt that safety is the cornerstone of our practice. However, caution and prudence should not be deterrents for innovation. On the contrary, if younger surgeons or trainees have the luxury of being attracted to innovation, it is only because their mentors use established methods and strategies. This creates a setting of safety and security in which younger surgeons are rooted. The established surgical practice needs to be one of absolute focus on safety; only then can the younger generation be comfortable enough with the current technologies to look into its shortcomings. Just like creating a safe household and offering children a rigid set of ground rules and education, anchoring residents in safety is a critical initial step. But at some point, your children will need to experience their own life. And if you hamper that, your kids will never surpass you... The role of mentors is therefore to teach and give trainees the tools to practice surgery safely. This will allow them to recreate the same environment of absolute attention to safety for their own patients. Surgical curriculums are aimed at training residents to reach this stage, not to surpass it. It is good, but not good enough. Once surgical training has been appropriately achieved, it is also the role of mentors to push trainees to venture out further and not fall asleep in the safe mode. They should be encouraged to keep searching. If we want