What if the future of surgery is not defined by what we can do, but by what we can avoid?

For more than a century, medicine celebrated its ability to intervene, to cut, repair, replace, and rescue. Today, however, some of the most important advances are emerging from a different philosophy: achieving better outcomes through fewer complications, less pain, lower opioid exposure, and smarter systems of care.

This Special Issue explores that paradigm shift. From opioid-sparing anaesthesia and perioperative pain management to surgical safety checklists, artificial intelligence, ethical competence, governance frameworks, and healthcare systems improvement, the articles gathered here share a common thread: excellence is no longer measured solely by technical success. It is measured by the quality, safety, and humanity of the entire patient journey.

The operating room is often described as a theatre. Yet the greatest performances are not those with the most dramatic interventions; they are those in which risk is anticipated, suffering is minimized, and harm never occurs.

Science advances through answers. Progress advances through better questions.

As you engage with this issue, I invite you to reflect on a question that will shape the next decade of perioperative care: how do we make surgery not only possible, but wiser?

The future belongs to those willing to challenge tradition, rethink assumptions, and redesign care around the patient rather than the procedure.

Welcome to Volume 2, Issue 2 – Special Issue 2026.

With warm regards,