What's new in...general surgery.

It might be imagined that apart from the quantum leap in technology imparted by the arrival of laparoscopy and endoscopy, there is little scope to modify surgery that has stood the test of time over many decades. That is a consideration when thinking only of operative surgery and as all surgeons young or old will tell you, surgery encompasses much more than just operating – it is the management of surgical disease. Casting ones mind back to medical school, management of disease starts with diagnosis and runs through everything we do to the patient until we have finished treating them and viewed in this context there is enormous scope for changes and improvements in surgical practice. One prominent theme throughout this review of recent advances in the four major subspecialities of general surgery, is the contribution made to surgical management by non-surgeons, be they radiologists, oncologists or even robots. Some are already integrated into routine practice, others require further confirmatory trial results before evidence-based changes in surgical management can take place.