Potential Barriers to the Diffusion of Surgical Innovation.

Althoughmanymodernconceptsandprinciplesof innovation have been defined according to the business perspective, the field of surgery, built on a unique cultureof continuous innovation, representsanareawhere 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 thepracticaluseofanewtechnology, technique,orsome 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 curiositymay leadtothe initiationofa researchprojectwherebynewtechnologies andconcepts are tested using cell lines and animals in research laboratories or with large data sets using epidemiological or statistical methods. Incontrast, 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.2Whilemanysurgical innovationspresuppose some form of research, not all research leads to innovation.Barriers tocrossingthis translationgapcan be related to 3 general clusters of influence: the role ofmarket forces and economic limitations, ethical considerations of innovative surgery, and the potential conflicts of interest associated with the use of surgical innovations.