Toward a “New School” of surgical research

In the last issue of the Canadian Journal of Surgery, Dr. Ed Harvey highlighted the recent decline in successful grant applications for funding of innovative surgical research.1 Each era of development in surgery seems to reach a point of congestion from which progress looks impossible. Faced with incrementally smaller gains, its participants resort to self-congratulation: “We are lucky to have lived through this time because such progress will never be seen again.” Have we too reached this point? For example, we have used the same immunosuppressants against rejection after transplantation for a quarter of a century and face the prospect of being unable to develop new therapies because 1-year survival rates of 95% leave little room for improvement.2 Cancer chemotherapy research appears to be trapped in the doldrums where clinical trials of endless recombinations of similar agents prevail. Or consider minimally invasive surgery, where great technological efforts are made to reduce the number of port sites, which, in effect, spares the patient a couple of rapidly healing 5 mm stab wounds. And is this the explanation for the virtual disappearance of preclinical bench research from our academic programs