What draws most to surgery is the ability to concretely effect change on an individual patient's life. However, we also recognize the human element of surgery. Multiple studies have demonstrated that surgeons who perform a procedure with more frequency, on average, have better outcomes. We spend thousands of hours through internship, residency, and fellowship followed by several career-defining years in our early practices as attendings striving to reduce the variance in our outcomes. While complications are inevitable, we hope that as we develop consistency they will become less frequent.

Computerized surgical planning is another tool that has the power to improve accuracy, safety, and reproducibility in our results. It does not replace surgical judgment nor can it overcome inadequate preparation or training. However, computerized surgical planning has greatly evolved since its first descriptions approximately 40 years ago. Just as computed tomography angiography has improved surgical planning for microvascular free-flap surgery, computerized surgical planning similarly can streamline the surgical process.

Like most new technologies, the innovation often precedes the application. With time, we have done what plastic surgery has always been known to do: we innovate. Now, computerized surgical planning is applied in more and more procedure types and at each stage of the surgery. The authors of this issue each have made unique contributions to push the limits of this technology. Some have questioned whether the increased cost and surgeon time to plan surgery is justified by the increase in accuracy or safety. On a basic financial level, in many cases planning can shorten surgical procedure time through streamlined decision making thereby recouping costs through operating room time utilization alone.

In the end, we must remember that the technology is an outgrowth of our existing surgical abilities and not the other way around. Internists often bemoan the lost art of the physical examination or the subtle signs of percussion or auscultation now supplanted by reliable imaging and diagnostic testing. It is important that as surgeons we are not bound by our technology and remain comfortable performing the procedures without the added benefit of planning. Many surgeons who perfected their craft before the advent of computerized surgical planning obtain fantastic results through their experience alone. My hope is that computerized surgical planning will enable us to reach higher levels of surgical fidelity. However, at the very least, computerized surgical planning democratizes the process allowing a great proportion of surgeons to achieve consistently high-quality outcomes.

Article published online:
07 August 2024

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