Public lecture as part of a search committee for a professor in General Surgery.

Summary: In general and highly specialized surgery, technical excellence alone is not sufficient to ensure optimal outcomes. Even after procedures performed at the highest technical level, complications, particularly infections, occur unpredictably and remain a major source of morbidity and resource utilization. Analyses of patients undergoing major abdominal surgery demonstrate that postoperative infections originate through bacterial translocation of the patient’s own intestinal microbiota. Complementary large-scale electronic health record analyses identify specific intraoperative stress responses as contributors and enable individualized risk prediction. Integrating such biological insights with data-driven risk assessment supports a more personalized approach to surgical care, reducing complications and improving outcome predictability in high-performance surgery.