Introducing a surgical innovation is necessarily challenging, requiring a complex pathway of device regulation and translational clinical trials to confirm safety and efficacy. However, to ensure adoption and uptake, a critical component of a device's pathway to market is engagement with surgeon stakeholders, and where possible, co-development. Achieving an integrated approach to this can prove challenging, particularly in the context of pre-clinical testing.

We discuss and explore the use of emerging technologies which provide alternate, 'tissue sparing' interfaces for testing surgical tools and technologies. Case studies will be discussed in the context of virtual reality and mixed reality environments as well as advanced cell cultures and 3D bioprinting. Applying 'bio-inspired' engineering simulation throughout development and the regulatory approval process promotes innovation, while reducing costs, shortening time to market and meeting safety standards and product deadlines.