Pitfalls in the surgeon's use of technology

The huge array of technological methods developed to help surgeons offers enormous benefits, but also pitfalls when surgeons apply the technology without being aware of its limitations. Three assumptions contribute to the pitfalls: the assumption of applicability - a surgeon assumes that the technical data are applicable to the pathological process; the assumption of reliability - a surgeon assumes that the data reliably represent the pathophysiological process; and the assumption of responsiveness - a surgeon assumes that the data are responsive to changes in the pathophysiological process. Three functioning principles in surgery are identified: that there is a constant relationship between the anatomical representation of a disease and its pathophysiological process; that biochemical or physiological tests adequately track the clinical progress of a disease or its treatment; and that specific treatment is directly related to the pathology and will alter the pathological process. It is shown how the three assumptions combine with the three functioning principles to produce common pitfalls in the clinical management of surgical patients.