Surgical innovation is something of a gray area in medical research. Relative to other doctors, surgeons exercise a high degree of discretion in the trialing of new techniques with their patients. The first patients to undergo a new procedure are, in a real sense, subjects in an experiment. It is always hoped that a new procedure will deliver a clinical benefit, but as often as not, trial means error. The frontline patients bear a higher burden of risk, with lower expectation of success than subsequent patients, who benefit from the experience gained in the early attempts.
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