Research in surgery: The adversities that every surgeon should know and face

•Despite a rich history of surgeon-researchers, there is a perception that basic science and clinical research has lose relevance in surgery lately.•Conducting an RCT in surgery is methodologically challenging and other sources of evidence may suit better in some cases.•The learning curve effect must be took into account when reporting results.•Placebo and blinding are not always possible nor ethical in surgical research.•The dual-role of surgeon and researcher makes for the patient hard to distinguish between clinical practice and research methods.