Using the Operating Room as a Laboratory

Abstract

Collection and documentation of data from patients during surgical procedures are highly useful but seldom used methods of surgical research. Intraoperative clinical research provides important information, whether the reports are descriptive or randomized controlled interventional trials. Clinical application of surgical techniques has increased dramatically following perioperative documentation of their benefits. At the University of Toronto, the use of blood cardioplegia in cardiac surgery increased from approximately 10% in 1980 to 98% in 1989, following identification of its beneficial effects on myocardial metabolism, ventricular function, morbidity, and mortality. Although the benefits of a surgical technique evaluated in the laboratory may influence many surgeons, improved clinical results have a greater impact on clinical practice. Extended tracheal resections were performed in dogs for many years, but Grillo and Pearson’s validation of the techniques in humans permitted their widespread clinical use.