This is the main conclusion of the seminar recently celebrated at the European Parliament entitled "Innovation in surgery: A solution for European health and societal challenges". Sponsored by Mrs. Avril Doyle, Member of European Parliament, and organised by the Society for Medical Innovation and Technology (SMIT), this meeting brought together medical experts, researchers, and government officials. The main goal was to discuss the latest advancements in the field and devise possible ways to boost support for surgical R&D.
As the representative from SMIT, Professor Di Lorenzo, explained, innovation and research in surgery is only driven by a market-based approach with American businesses completely dominating the sector. Companies only develop tools and instruments that may be profitable. For that reason, he stressed the importance to have public support to develop technologies that are not marketable, especially those aimed at treating rare diseases. In his opinion, the European Union and its Member States are "in a position to lead and collaborate" at the same level but this change has to be initiated by new funding mechanisms and government support.
Professor Di Lorenzo also highlighted the importance of surgical R&D from an economic point of view. Certain procedures to treat diseases such as diabetes can be an effective cure in more than 50 percent of the cases, a much higher success rate and less costly option compared to life-long drug therapies. Surgery has also proven to be particularly effective treating what is now as Diabesity, the combination of obesity and type-2 diabetes. The treatment of Alzheimer's using surgery is an area which is still in its very early stage but initial results show that it could be a promising one for the field.
All the participants agreed on the need to have surgery research included in future health work programme of the Seventh Framework Programme which is currently focused on the development of new drugs. Today, there are just 25 R&D projects being developed in FP7 that have something to do with surgery and most of them fall in the areas of ICT and nanotechnologies. As the representative from SMIT explained, surgery has been left out because it is generally not so "cutting-edge" as for example other lines of medial research such as genetics or biotechnology. However, the real impact of surgical developments in the last two or three decades has already proven to be more valuable for the life of European citizens.
One of the main obstacles for surgery to achieve adequate recognition has been the low level of participation from surgical associations in the definition of research priorities in Europe. Professor Di Lorenzo defined surgeons as "very strange animals, very individual" and asked them to become more active in setting up networks to collaborate and exchange ideas. This problem has also been partly due to the enormous fragmentation of the field into many specialisation areas such as general surgery, cardiovascular, ophthalmology, orthopaedics, etc. In his opinion, "there is an absolute need for surgery to act with just one voice" so research needs can be heard by the governing bodies and new support mechanisms can be put into place.
Finally, the attendees had the opportunity to learn about the possibilities of simulation in surgery to accomplish three clear objectives: First of all, to train new surgeons and speed up the learning curve to become certified. Second, to asses in advance who is best suited to become a surgeon and therefore help cutting the unnecessary costs of excessively long training times for people who are not qualified to perform at the required level. Lastly, surgical simulation could also be used to periodically re-examine the ability of existing professionals something which is not the norm in most European countries.
At this meeting, the Society for Medical Innovation and Technology presented a position paper on the importance of innovation and research for the advancement of surgery. This document contains abundant data and detailed explanations about the contributions of surgery to modern medicine. It also includes potential ideas, both political and financial, to increase the level of support to develop new R&D surgery-led projects in the European Union.
Some examples of innovative projects mentioned in this seminar included:
- the Vector Project which aims at investigating and developing a miniaturised robotic endoscopic pill for advanced diagnostics and therapy in the human digestive tract.
- the Ares Project which aims at developing an entirely new type of surgical tools, capable of entering the human body through natural orifices - by insertion, ingestion or inhalation - or very small incisions (injection), and configuring themselves in complex kinematic structures at the specific site of intervention.
- the Araknes Project which stands for Array of Robots Augmenting the KiNematics of Endoluminal Surgery.