Shape of things to come

Conclusions

Real progress in endoscopic surgery will be derived from sound prospective evaluation of surgical procedures, their safety, health, economic considerations, and long-term outcome in addition to technological progress. Endoscopic surgery will be facilitated by a new generation of steerable sensing instruments, which will restore the current kinematic resections and tactile feedback. A systems-based operating console will soon replace the ergonomic chaos prevalent in operating rooms at present. The future for telerobotic, as opposed to telemanipulative immediate remote surgery, is limited. Endoscopic and open surgery will come to be seen as integral components of one surgical therapeutic approach. Whatever transpires from the emerging technology, we must not overlook surgical principles governing operative intervention, which apply regardless of the approach and instrumentation. In the end, it does not matter how a surgical procedure is performed, but that it is done well and to the patient's benefit.