The future

Although there is no doubt that minimal access surgery has changed the practice of surgeons, it has not changed the nature of disease. The basic principles of good surgery still apply, including appropriate case selection, excellent exposure, adequate retraction and a high level of technical expertise. If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach.

Improvements in instrumentation and the development of structured training programmes are the key to the future of minimal access surgery. It is certain that there is much that is new in minimal access surgery. Time will tell how much of what is new is truly better.

The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence, the more exquisite his healed wound. (Lord Moynihan of Leeds)