Closing the global surgical divide: histotripsy, a pathway to universal access?

Five billion people, more than half of humanity, lack access to safe, affordable surgical care. While conventional surgical infrastructure requires decades and trillions of dollars to replicate in low-resource settings, emerging non-incisional technologies offer an alternative paradigm. Histotripsy is a focused ultrasound modality that mechanically destroys tissue without incisions, anesthesia, or prolonged hospitalization. It represents a potential leapfrog technology for addressing the global surgical divide. This editorial examines the technical, economic, and implementation considerations that position histotripsy as a transformative intervention for global surgical equity. We propose a framework for accelerated deployment and outline the policy, research, and financing mechanisms required to realize this potential within a generation.