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Invited Critique
September 01, 2007

Surgery Without Scars—Invited Critique

Arch Surg. 2007;142(9):826-827. doi:10.1001/archsurg.142.9.826

Surgery, gaining much from the general advance of knowledge, will be rendered both knifeless and bloodless.—John Hunter, London, England, 1762

After 2 centuries of progress in maximally invasive surgery, it seems that much progress toward Hunter's prophecy of “rendering surgery both knifeless and bloodless” has been made in the last 2 decades. In Georgian England, the achievement of such a goal more concerned the elimination of incisional pain than worry its cosmetic consequences, as Hunter's work preceded general anesthesia by more than 80 years. Nevertheless, incisionless, painless, scarless surgery has become the Holy Grail of modern surgical minimalists. Transvaginal cholecystectomy is a step in that direction. Or is it? Does this article by Marescaux et al merely record a triumph of technology and surgical panache such as landing a man on the moon, or does it represent another step toward truly noninvasive surgery? To answer this question, one must dissect further, to examine the measurable benefits of such an approach.

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