The late 1980s heralded the start of what is widely acknowledged as a period of enormous technological change in surgery, particularly, but not limited to, minimum access surgery either displacing conventional open surgical techniques or providing new opportunities for surgical treatments. This article by Johnstone discusses the main technology‐related factors contributing to the significant, but unanticipated, labour intensification of surgical production within operating departments—reasons that are not consistent with the pervasive theme of the techno‐economic literature that generally equates ‘new technology’ with automation, labour displacement, work simplification, and the economic benefits accruing to an organisation.