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Commentary: Craniopagus separation, a model for innovation in surgery

      Innovation in surgery has a long and storied history, as all surgeons are motivated by the desire to do better for their patients. Every surgical discipline modifies and adapts new technology, building on previous work as the entire field attempts to advance. In the science of surgical advancement, a typical path exists regarding how an innovation is brought to practice. Small cohorts are used to first introduce an innovation before testing it in larger cohorts; eventually, it is tried by surgeons around the world to determine generalizability. When potential benefit is seen, the cumulative results are then compared with standard of care to determine risks, establish benefits of the innovation, and determine which patients benefit the most from it. This process typically takes years, involving thousands of patients and surgeons.
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