I've often wondered how much pressure surgeons feel to complete "high-tech" surgeries such as laparoscopic cholecystectomy because patients have come to expect surgery to be done in the least invasive manner possible, neglecting to understand that not every surgery can be safely performed with the least invasive approach. Further, the need for greater utilization of resources postsurgically may weigh on the minds of some physicians.
With news shows that speak of "minimally invasive" surgeries and making them sound so attractive in terms of recovery time, scarring, postsurgical pain, etc., patients don't understand that it isn't always possible to safely complete surgery in such a manner.
Thank you for your thoughtful post. In the exanple of laparoscopic cholecystectomy you provide, it would be a far greater benefit to the patient to ensure the safest procedure than to deal with bile duct injury or other complications after surgery.
Speaking as a non-surgeon, I think intuitively the practice of surgery remains in the eye of the surgeon.
By that I mean that, from the surgeon's point of view, what is happening is what he perceives is happening.
Open cholecystectomy itself has limitations on how well one can see what one is doing, and even with the best optics and equipment, a laparascopic procedures' aim is to visually be "good enough."
One of my colleagues (also not a surgeon) suggested once that the diagnostic and judgment skills and the technical operating skills of surgeons can many times be independent features of a surgeon. One would always hope that ones own surgeon is good at both, but one can certainly sense that some surgeons are much better at one than the other.
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