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David R. Flum, MD, MPH; John L. Zeller, MD, PhD; Phil B. Fontanarosa, MD, MBA

JAMA. 2009;301(2):218.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

It is estimated that, worldwide, more than 230 million major operations are performed each year.¹ Surgical procedures may encompass a wide spectrum of complexity and indications, from emergency interventions (such as appendectomy), to lifesaving or life-extending operations (such as liver transplantation), to elective surgical interventions (such as total joint replacement), to cosmetic surgery procedures (such as breast augmentation).

Major developments such as the expanded use and applications of minimally invasive techniques, an increasing proportion of operations and interventional procedures conducted without the need for hospitalization, and recent emphasis on the importance of critically assessing outcomes of surgical care are changing the practice of surgery. With the worldwide growth of surgery, the appropriateness, effectiveness, safety, cost, and relevance to other components of health care are being increasingly scrutinized. Research in surgery has shifted focus from technical . . . [Full Text of this Article]

Author Affiliations: Drs Flum and Zeller are Contributing Editors and Dr Fontanarosa (phil.fontanarosa@jama-archives.org) is Executive Deputy Editor, JAMA.

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