Technology Advancements, the Surgeon and the Patient

The field of cardiothoracic surgery was born from the development of technology and has developed alongside technological advancements. With a rich tradition of technological innovation, cardiothoracic surgery is a constantly transforming field which, throughout time, has seen most of its procedural progressions improve in relation to technical growth and developments.

"Technological growth has transformed many of the most common cardiothoracic surgical procedures and has led to new operations for previously untreatable disease, like hypoplastic left heart syndrome (HLHS)” (Iribarne et al., 2009). If we look at the history of HLHS treatment, it was only around 1979 that the staged reconstruction used to treat the congenital heart defect (CHD) become available to infants who were affected by the defect. Cardiac transplantation, which is now considered as an alternative therapy due to the shortage of neonatal donor organs, was the primary mode of treatment - which proved to be an insufficient approach for the entire population of infants born with HLHS each year. With technological developments and “more contemporary experience”, there has been a rise in both short- and long-term survival (Ming-Sing, 2014).

What do the advancements mean for our surgeons?

Technology developments mean the cardiothoracic surgeon is able to manage and treat defects in new and different ways. New operations, or rather a “modification of operative techniques” are thus made manifest and the possible reach and treatment pool is enlarged for the surgeon. For cardiothoracic surgeon, Dr Hendrick Mamorare, “the diagnoses are more precise which implies that the planning for the procedure is undertaken with a lot of information at our disposal”.

For the surgeon interacting with new technologies, there is a need to learn and practice new techniques. Delivery of care, costs and treatment and recovery time are just a few dynamics presented to the field with each and every major advancement. The advancements additionally carry with them an array of ethical, moral and legal implications. The Society of Thoracic Surgeons (2006) “warns that the pace and rate of technologic change has increased to the point that an established procedure begins a challenge of [becoming outdated within] seven years.” Surgeons, thus, may experience slight stress in an attempt to keep up with the latest techniques and technologies - which have ultimately been developed to be of benefit to the individuals affected by heart and lung defects. However, on the other side of the coin, technology may also give to the surgeon a great sense of comfort in that they have access to great insight into each case prior to opening up the chest and know that they “now have tools to interrogate repairs at the end of a procedure as well as to optimize the repair before the patient leaves that operating room” (Dr Hendrick Mamorare).

What do the innovations mean for our patients?

Within the cardiothoracic field, most technological advancements are driven to allow for less invasive approaches and treatment in addition to the goal of increased reach and longevity. Dr Mamorare confirms that most investigations are non-invasive as a result of technology.

Patients that would previously have been considered ineligible, for example the elderly, or those who were affected by defects in which the risk of treatment would be greater than that of the possible benefits, are now able to receive treatment due to improvements in surgical techniques and technologies (Iribarne, 2009). The evolution of equipment and surgical tools, to become smaller, also mean that very small patients are also able to receive appropriate and successful treatment. How have technological advancements in the medical field impacted your life, if at all?

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© Maboneng Heart and Lung Institute 2017 | Featured Image: Malaika Boon​ Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935793/ (Iribrane et al., 2009) http://www.annalsthoracicsurgery.org/article/S0003-4975(05)02125-9/abstract (The Society of Thoracic Surgeons, 2006) https://emedicine.medscape.com/article/904137-overview#a5 (Ming-Sing, 2014)