The science behind thoracic surgery: a brief preface

If you can’t explain it simply, you don’t understand it well enough. —Albert Einstein

Science could play a significant role in thoracic surgery because thoracic surgery is a field where the researchers, from data and techniques derived from more disciplines, are combined to solve problems where solutions are beyond the scope. It is the rapid development of physics and chemistry, underpinned by mathematics, which has made medical advances possible: the development of the microscope; the discovery and use of radiation for diagnosis and therapy; the explosion of clinical laboratory investigations for diagnosis and prognosis. Therefore, it behoves every thoracic surgeon to have a basic understanding of the underlying science to obtain a three-dimensional point of view of surgery, as not just a technical art but also as a precision science. Since it is from science, or how things work, that technology, or how to get things to work, emerges. The modern-day thoracic surgeon should understand the fundamental basis of the functioning of technological instruments used. Because, as stated by Grady Booch a fool with a tool is still a fool, the technological instruments are as safe or hazardous as the surgeons who are using them.

Everything occurs in circular sequences: revolution, change, adaptation to change, acceptance of the new standard, organising the new establishment, resistance to further change, revolution, and the cycle begins again. In surgery, this cycle had been occurring about every 100 years, but recently there has been a perceptible acceleration of this cycle. New scientific advancements could privilege thoracic surgeons in expanding an existing skill set or could achieve thoracic surgeons to perform new procedures outside the traditional boundaries of thoracic surgery.

Nonetheless, science is accelerating quicker than ever, and we are on the edge of another revolution. This is a time, in the history of thoracic surgery, when the truthfully revolutionary transformation is occurring at a rate never seen before. While it is a historical fact that each generation of physicians significantly exceeds the accomplishments of the previous generation, the magnitude of actual changes is extraordinary. The surgeon of the future will need to absorb a broader range of the modern sciences, quicker than ever before. Although the exact sciences (like mathematics, physics, engineering) are perceived by most people as far away from the more experimental surgery, indeed the modern surgery has its foundations in them.

This special issue of the Shanghai Chest would like to make the bold effort of inquiring the scientific laws, mathematical principles and new technologies behind thoracic surgery by involving engineers, mathematicians, physicists, biostatisticians and medical doctors and creating a sharp dialogue between all these disciplines. All that in the conviction that mutual exchanges can improve knowledge in thoracic surgery field and promote the progress.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Shanghai Chest for the series “Science behind Thoracic Surgery”. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/shc.2018.08.01). The series “Science behind Thoracic Surgery” was commissioned by the editorial office without any funding or sponsorship. LB served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Shanghai Chest from Jun 2017 to May 2019. The authors have no other conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Luca Bertolaccini

Dania Nachira