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Potential Barriers to the Diffusion of Surgical Innovation

Faiz Gani, MBBS1; Daniel E. Ford, MD, MPH2; Timothy M. Pawlik, MD, MPH, PhD, FRACS(Hon)1
[+] Author Affiliations
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA Surg. 2016;151(5):403-404. doi:10.1001/jamasurg.2016.0030.
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This Viewpoint discusses the barriers that prevent surgical innovation from being implemented in practice.

Although many modern concepts and principles of innovation have been defined according to the business perspective, the field of surgery, built on a unique culture of continuous innovation, represents an area where creativity and initiative have been central to progress. Surgical innovation can be thought of as the introduction of new concepts and ideas or, more specifically, as the practical use of a new technology, technique, or some combination of both.1 Given that there are no accepted definitions for surgical innovation, it is important to delineate between surgical research and innovation. Surgical curiosity may lead to the initiation of a research project whereby new technologies and concepts are tested using cell lines and animals in research laboratories or with large data sets using epidemiological or statistical methods. In contrast, innovations typically represent the practical application or intended use of these concepts and ideas in humans.1 Although this bench-to-bedside pathway has received considerable attention over the past 2 decades, there is increasing awareness that the transition from theoretical ideas to use in humans occurs infrequently.2 While many surgical innovations presuppose some form of research, not all research leads to innovation. Barriers to crossing this translation gap can be related to 3 general clusters of influence: the role of market forces and economic limitations, ethical considerations of innovative surgery, and the potential conflicts of interest associated with the use of surgical innovations.

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