The_Invention_of_Surgery

federal spending on health care could increase 1,700 percent in half a
century? Outcomes in the treatment of cancer, heart disease, and arthritis
have dramatically improved in the last fifty years, but the question
remains, how much are we willing to pay?
Some healthcare critics have cited a doomsday event of sorts wherein
one day we might spend more money on healthcare than our mortgages.
Even acknowledging the tragedy of uninsured Americans and poor
healthcare outcomes among disadvantaged families, shouldn’t we
prioritize the health of our bodies above the status of our houses?
Hopefully, we can avoid that mathematical reality, but a bit of the sting of
sticker shock is placated by an appreciation of how very far we have come
in the last seventy-five years.
A tabulation of implantable medical devices will now be offered. The
simplest way of accomplishing this will be by specialty, but because there
is no national registry this is a daunting calculation. The methodology is
based upon a combination of US federal government information and
industry reports. Both require the purchasing of reports and the
consultation of experts.
A review of implants based upon their longevity (temporary versus
permanent) and structural makeup was proposed (organic, biological,
plastic, metal, and electronic). Every implant that exists in a human can be
described as some combination of those descriptors.
Another way of categorizing implants is based upon their function.
Implants are used for: repair, reconstruction, substitution, stabilization,
restoration, augmentation, and electrical stimulation. This classification is
mine, and is presented, not as a factual representation but as a conceptual
approach.
Repair implies the realignment of our own tissues, like sewing
lacerated skin edges together or attaching tendon edges to a bone, like
rotator cuff repair. Repair almost always entails the use of suture, and
more often than not, permanent suture that is intended to stay forever.
Open-heart surgery and repair of the mitral valve (between the left atrium
and left ventricle) involves a great deal of permanent sutures and,
oftentimes, a permanent reinforcing mesh ring for annuloplasty.
Reconstruction involves implanting a new tissue into a specific area
with the expectation that the body will (miraculously) respond by: 1) not
rejecting the tissue, 2) microscopically responding by accepting and