Forward We Go!

History of modern day minimally invasive surgery, where we are now, and where we are going to standardize and democratize surgery.Technology has revolutionized many aspects of our lives from space to social media and telecommunication.Medicine and surgery have been one of the last beneficiaries of this advancement in technology.We predict this will change rapidly, revolutionizing medicine and surgery to standardize and democratize it.Here is how we see it happening. . .The first successful vertical laparotomy was performed in the early 18th century by Dr. Ephraim McDowell and was initially negatively received by authorities in the medical community.Dr. James Johnson, the editor of the Medico-Chirurgical Review of London in 1817 wrote, "In spite of all that has been written respecting this cruel operation, we entirely disbelieve that it has been performed with success, nor do we think that it ever will."Over a decade later, Dr. Johnson issued an apology:"A back settlement of America -Kentucky, has beaten the mother country, nay, Europe itself, with all the boasted surgeons thereof, in the fearful and formidable operation of gastronomy with extraction of diseased ovaria. ... There were circumstances in the narrative of some of the first three cases, that raised misgivings in our minds, for which uncharitableness we ask pardon of God and Dr. McDowell of Danville."One hundred years after Dr. McDowell's success, Dr. Hermann Johannes Pfannenstiel performed the first transverse laparotomy.He also, was criticized.It took another 100 years for the outcomes to be published, confirming Pfannenstiel's transverse laparotomy had lower complication rates than the traditional vertical approach. 1A similar progression has been seen with developments in endoscopy.The first endoscopy was done by Dr. Philipp Bozzini in the 18th century who used a light carrying instrument, a Lichtleiter, to look inside the bladder.Yet, it was not initially accepted.One hundred years later, Dr. George Kelling performed the first laparoscopy in the early 19th century. 2,3Other virtuosos including Dr.