Abstract

It is a well-known conception, popularised in the mid-nineties, that surgical research in the UK was no more than a ‘comic opera', with few exceptions.  Regrettably, much of this carried truth. ‘Many questions were being asked, but few answers were given.'¹

Root causes were multifactorial, including the complexity of conducting high quality research by craft specialties, the lack of protected academic time, ill-designed career structures, and expectations of competitive outputs by Higher Education Institutions, particularly through the Research Excellence Framework. A further hindrance to high quality surgical research has been the antiquated ‘silo' culture entertained by many surgeons, and lack of multidisciplinary research approaches to unmet needs in surgical practice.

Many of these issues have been addressed and resolved over the past two decades. From new, structured surgeon scientist careers to well-funded high impact clinical trials, innovation and testing of interventional technologies, surgical research is now thriving in the UK, and can be re-defined as follows:

"Where conventional and/or minimally invasive surgical interventions can be tested, compared and evaluated, including the precise delivery of ablative energy. Where surgical techniques, used alone or in combination with other treatment options (physical or systemic) can be investigated to improve outcomes and cure, enhanced by functional imaging, whilst reducing adverse events from individual treatment options. And where surgical interventional procedures can be improved by targeting the right patient through novel and experimental genetic, epigenetic or biochemical markers.'

1. Horton R. Surgical research or comic opera: questions, but few answers. Lancet. 1996 Apr 13;347(9007):984-5.