Innovative approaches to preoperative care including feasibility, efficacy, and ethical implications: a narrative review

Background and Objective: In the face of advancing technologies and a greater understanding of human physiology and psychology, preoperative care is on the cusp of a paradigm shift. Healthcare is moving towards an emphasis on holistic care and technologies such as those of artificial intelligence (AI) are being implemented rapidly. This review aimed to explore innovative approaches and discuss their implications to preoperative care. Ultimately, a concise summary of feasible and effective strategies is provided for clinicians and health systems to consider adopting. Methods: A literature search was performed in multiple databases including PubMed, Scopus, Web of Science, and Cochrane Library, spanning from September 2013 to August 2023. English-language peer-reviewed articles, clinical trials, reviews, and meta-analyses relevant to innovative strategies in preoperative care were sought and reviewed. Key Content and Findings: Two themes of innovative approaches were recognized—personalized holistic care and technological integration. Personalized holistic care consisted of non-surgical specialty input, psychological interventions, prehabilitation, patient education, and genetic/epigenetic profiling. Technological integration consisted of the use of virtual reality (VR) and augmented reality (AR), telemedicine, AI and machine learning and finally three-dimensional (3D) printing. Conclusions: The amalgamation of pharmacogenomics to tailor pain management strategies, along with the use of patient-reported outcome tools indicate a shift towards personalized medicine. Emerging technologies like epigenetic marker technologies, AI, and telemedicine offer significant promise but come with a complex array of challenges that span ethics, cost-effectiveness, and quality of care. It is imperative to address these challenges through multidisciplinary research and ethical governance

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence