Intraoperative CRISPR editing: the feasibility of gene surgery inside the operating room

Intraoperative CRISPR editing is the application of gene-editing technology directly during surgery; it is a new era of molecular precision in operative medicine. By integrating CRISPR/Cas9 systems into surgical workflows, clinicians can correct pathogenic mutations or disable tumor-promoting genes in real time. This approach builds upon recent in vivo trials demonstrating safe, localized gene editing, such as subretinal CRISPR delivery in the US and CRISPR-modified T-cell therapies in China. Advances in viral and nanoparticle delivery, intraoperative electroporation, and rapid genetic diagnostics have made gene surgery technically plausible. Nevertheless, challenges remain in targeting efficiency, immunogenicity, and ethical oversight. With appropriate safety validation, standardized operative protocols, and transparency frameworks, intraoperative CRISPR could revolutionize surgical care by transforming the operating room into a site of direct genomic correction.