The two advances in the field of operative surgery in this century have been minimal access surgery and organ transplantation. The present generation of trainee surgeons should be well versed in either or both of these divisions.
These days there's hardly any abdominal operation which cannot be done by laparoscopy. I am sure all the surgical curricula worlwide focus on training in laparoscopic surgery. But there's a catch here. The present generation of expert laparoscopic surgeons are all expert open surgeons as well. What drove them to attempt every surgery by a laparoscope is the confidence that they can manage these problems by open surgery pretty well.
But who will teach the present generation of students complicated open surgical procedures and techniques and to tackle complications arising out of lap procedures. It will certainly be interesting to see what will happen to the art and science of surgery say in 5 to 10 years time when most senior surgeons retire..
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Surgical advances started with trauma surgery. This surgery is unlikely to be taken over ever by lap surgery. I agree open procedure teaching will become increasingly difficult for young to be surgeons- the current simulators for lap surgery will need to be re-invented for open surgery - they will also need to be made more realistic for the trainees.
A real concern in the future.