Surgeons and the Scope

In Surgeons and the Scope, James R. Zetka Jr. describes the impact of the video laparoscope on the work lives of contemporary surgeons. The video laparoscope allows surgeons to peer into the inner abdomen with a miniaturized camera, thereby enabling them to perform complex operations without large incisions through small ports punched into the abdominal wall. This technological innovation revolutionized surgery as we know it. Zetka blends rich interview and archival data into a compelling account of an important technological development. He shows how the new laparoscopic technology challenged surgeons to rethink their approaches to surgery, to relearn basic hand-eye coordination, to master complex machinery, and to shift from individualistic to team-based work strategies. Zetka then explains how and why general surgeons embraced this disruptive technology by examining the breakdown of the division of labor between general surgeons and gastroenterologists in response to the unintended and unanticipated outcomes of the scope technology. In Surgeons and the Scope, Zetka weaves cultural, structural, and political economic developments into a sophisticated account of technological change. By viewing the advent of laparoscopic surgery within the context of the history, culture, and ideology of medicine, Zetka provides a deeper understanding of the politics of technology, particularly its effects on job skills, occupations, and worker control.

Our strength of Zetka's work is that he enhances his historical analysis of the intraoccupational competition within medicine with a workplace focus. This allows him to demonstrate the importance of location in the focus. This allows him to demonstrate the importance of location in the occupational division of labor; as a downstream occupation, surgeons were dependent on referrals to procure patients on which to work.... A simultaneous workplace and historical occupational study is a daunting undertaking, and Zetka does a laudable job of combining the two. Another strength of the work is that it lies at an interesting intersection of occupations, work, and technology.... Scholars interested in the diffusion of innovation would find much to like in his analysis of the cultural and structural factors involved in the adoption of the surgical scope., Surgeons and the Scope is the fifth volume in a Cornell University series on technology and work. The author is a sociologist who used interviews of practitioners, observations of videoscopic procedures, and archival materials to describe the interplay of forces in medicine and surgery and other factors that led to surgeons' development and control of laparoscopic surgery. The book is written as a sociological case study of the impact of technology on work and is a solid contribution to the sociology of occupations and professions. Moreover, those other than sociologists should also find it an interesting and insightful account of the development and impact of 'scope' technology.

James R. Zetka Jr. is Associate Professor in the Department of Sociology at the State University of New York, Albany. He is author of Militancy, Market Dynamics, and Workplace Authority: The Struggle over Labor Process Outcomes in the U.S. Automobile Industry, 1946-1973.