47. The business of endoscopic innovation

Innovation in surgery has tended to be characterized by periods of incremental improvements with distinct epochs of fundamental “disruptive” change. Open access to laparoscopic, laparoscopic to robotic, rigid endoscopy to flexible endoscopy: these shifts have brought about fundamental improvements in patient experience but have also required significant shifts in surgical practice. The process of medical innovation is driven by networks of physician innovators, entrepreneurs, investors, and large companies who identify and support innovative ideas and guide them to the market. This chapter explores this ecosystem and describes some of the fundamental disruptive technologies set to change current surgical practice.