Blockchain in surgery: are we ready for the digital revolution?

Excerpt

Throughout time, surgery evolved from an old fashioned and rough discipline to one of the most exciting fields in medicine, tightly linked to historical technological advancements. To cite only a few, minimal access surgery including laparoscopic and robotic surgery, real-time intraoperative angiography with fluorescent dyes and coherent laser imaging systems, 4K ultra-high-definition optics, 3D printing, virtual and augmented reality. Our daily practice has also changed with the introduction of electronic medical records, with the consequent possibility of running big data analytics and artificial intelligence algorithms. The latter will soon represent a major turning point in human history and, nonetheless, in surgery, although it may seem distant from our daily activities. Not taking part completely to the digital revolution will soon render our practice obsolete. In this process, it will be fundamental to manage the huge amount of digital data (patients’ data, surgical video footage, etc.) with maximum attention to security and digital privacy, considered a human right by the United Nations [1]. In 1982, a new protocol for secure storage of information based on a chain of data blocks was created by David Chaum, considered the “father” of modern-day cryptography [2], and expanded in 2008 by a person or a group of people under the name of Satoshi Nakamoto, that created blockchain. All kinds of information, including audio and video, can be secured in a blockchain, which is a specific type of database that stores data in programmable blocks, chained together in a chronological order. Once the information is on the blockchain, it becomes accessible to all the network participants and cannot be altered or counterfeited, thus protecting from fraud and cyberattacks, as every action leaves a trace. Blockchain technology is freely accessible and available to anyone, and one of its most famous real-world applications is the cryptocurrency Bitcoin. We would like to share some of the less known applications of blockchain to the medical field and point out how this technology can contribute to the evolution of our surgical world (Fig. 1).

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