Responsible innovation in surgery: a proposal for an anonymous registry of surgical innovation

Abstract

Surgical innovation exists in an ethical and regulatory no-man's-land; its inherent risks necessitate careful ethical consideration, but its ad hoc nature makes it less amenable to forms of regulation typically associated with formal research. One solution, which has been proposed in the surgical literature, is to keep a registry of surgical innovation. For numerous reasons, however, such a registry does not currently exist in the USA or elsewhere. Here, we propose an innovation registry with the following characteristics: online, anonymous, secure, organized by specialty and diagnosis, keyword searchable, and containing an interactive forum for posting comments on individual innovations. We argue that such a registry would be a valuable tool for promoting responsible innovation in surgery. Furthermore, we report the results of a pilot study, which suggest that such a registry could be successfully implemented in the USA.