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E.O.E Newsletter | www.huanet.gr
anymore, I just follow my steps. And I think you should have the same mindset whatever procedure you’re doing. You cannot proceed with the next step, if you haven’t actually finished the first step. Because, for me, that is one of the most common things I see in beginners. They don’t finish one step before going to the next step, and when they go a little bit further in the surgery, they will have a problem, because they didn’t finish the first step properly. Planning is very important and don’t forget that surgery is a science, it’s not art. You operate with your brain, not with your hands! The most important thing is how you plan the procedure!
F.N.: In 2003, when you pioneered robot-assisted cystectomy, with total intracorporeal neobladder, what was the reaction of the urological community in the world?
P.W.: It was very mixed I can tell you! Like always, if you come with something new, then there is a lot of criticism. There was a lot of interest I can say, but there was also a lot of criticism. But I knew and I was 100% sure from very early on that, in our hands, at least, our patients had really good outcomes. Because I followed
all patients (from patient number 1) and I mentioned all the complications, the oncological outcomes and everything. And unfortunately, bladder cancer is a disease which is very malignant for some patients and they will die very quickly. And it is also a very unforgiving procedure. So, if you don’t follow the correct surgical planes, you can have positive surgical margins or you can open the bladder. You may actually kill the patients, if you spread the cancer. So, you have to be very careful. But I had done many many hundreds open procedures with bladder cancer before, so I had basic practice of how to do the operation. And you can use the same principles when you go robotically. But there was a lot of criticism and it was not until the last few years that there is almost no one telling me “Your outcomes are not good or you have more complications”. Some of the most famous urologists accused me of lying about my results and it was very strange!
T.S.: Except being an exceptional surgeon, you are also a talented instructor and mentor. Do you believe that teaching others has an impact on your skills as a surgeon?
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