[Trends in surgery--evolution or revolution?].

BACKGROUND:In recent years surgical procedures have developed enormously outpacing the rapid growth in medicine. OBJECTIVES:The aim of this article is to highlight the trends in surgical treatment over the past decade in comparison with reports in the scientific literature. METHODS:We reviewed the surgical trends in the Pediatric Surgical Department at the Sheba Medical Center between the years 1995-2006. The main parameters implemented in the assessment were: laparoscopic approach vs. traditional open surgery, elective vs. emergency operations and the extent of congenital abnormalities treated over the years. RESULTS:This study showed a decline in the number of open surgeries performed as opposed to a statistically significant increase in laparoscopic procedures and a decrease in elective surgery performed in tertiary medical centers, while the number of congenital abnormalities treated remained constant. CONCLUSION:The literature review revealed that similar changes in surgical management were found in other countries, confirming our study results. These trends, including clinical, professional and fiscal developments, require preparedness on a national level.