Can surgery be submitted to the same rigorous clinical trials as drugs to ensure the right surgical procedures are being carried out? Or does the very nature of the craft make this impossible? Every operation is unique to each patient and the surgeon who carries it out. No two surgeons will ever carry out the exact same operation. How do we know therefore, which procedure is best?

The answer is not straightforward. What if a surgeon decides to alter regular surgery in some way. How does he or she evaluate whether the new alteration is better than the old? If the same were to happen with a drug, it would take six or seven years to make one ingredient change, carry out randomised clinical trials to test the safety and efficacy of the alteration before coming into use. Not so with surgery.

By its very nature, surgery, a craft, is dependent on the surgeon carrying out the operation, on the patient before him and on the manifestation of the disease he is dealing with in that patient. No two patients are the same, and thus no two operations will be the same.

Although 30% of hospital admissions require surgery, only 2% of medical research funding goes into testing whether surgical procedures have a scientific grounding. Surgeons are now trying to alter that figure and see how this problem can be addressed.

In this programme Geoff Watts looks at the problems faced by surgeons and how they may be overcome.