Surgery, surgical education and surgical diagnostic procedures in the digital era.

Computers have quickly proven to be an essential part of routine, everyday clinical work. New disciplines are being developed: telesurgery (surgery at a distance), computer- and robotic-aided surgery, image-guided surgery, medical teleconsultations, postoperative telefollow-up, etc. What are the future directions of computer-aided medicine? The digital revolution in medicine, which we are currently witnessing, is leading towards the development of new surgical treatment modalities, toward surgical simulation and improved surgical teaching. The old surgical teaching rule, 'See one, do one, teach one' promulgated by Halsted is fading into history. There are new diagnostic tools expanding the available diagnostic modalities and turning their results into a more comprehensible form. Neural networks are being successfully introduced into differential diagnostics. The capacity of human hands is being increased by telemanipulation and movement downscaling. The cost of useful applications of computers is in many cases not as high as might be expected. Analogue telephone lines are often good enough for telemedical purposes, which is particularly important for developing countries. We review the current status of computer-aided surgery. It is presumed that surgery in the future will rely on computers to a much larger extent than today. All surgery will be to some extent computer-aided, or even completely robotic, but it can never be performed without human professional guidance, supervision and control.