Preface to the book This is life: the journey of uniportal VATS

It is my great pleasure to recommend this important book written by well-known and widely respected authors, including my long-term friend Dr. Diego Gonzalez Rivas.

I met Diego for the first time many years ago when I was his teacher in the notable European School for Cardio-Thoracic Surgery in Bergamo, which became the forge of many future world’s leaders in thoracic surgery. I was immensely privileged to lecture there a group of several young and enthusiastic adepts of our specialty from all over the world.

One word of explanation—the European School for Cardio—Thoracic Surgery in Bergamo was not an ordinary school, it was a center of excellence and the teaching was dynamic, as the masters were able to oversee the content personally. The masters’ adepts were continually being trained and thus there was the power of tradition combined with the flamboyance of the creative newcomer. However, this prestige was for me not only limited to lecturing.

Students were living in the old monastery, in very simple rooms like former monks and we all spent long hours together both in lecture halls and outside—discussing, provoking new ideas and points of views, quarrelling sometimes, and on top of that dining in many fantastic Italian restaurants carefully selected by our hosts. It was a fantastic time—I hope for both sides.

Diego was one of my students and I immediately noticed him as a natural leader, inventor and extremely vivid young man, who was working hard and seemed to be interested in all details of thoracic surgery, but also finding time to have some fun and relax.

Albert Einstein famously said that “Everyone knows that something cannot be done until someone comes along who doesn’t know that it’s impossible, and does it”—with this in mind we can make progress not only in medicine. Diego is actually a perfect example of such approach, but with one important difference—he knew what he wanted to invent and he did it on a basis of solid theoretical and laboratory background.

This was my dream as an academic teacher in Bergamo to inspire a bunch of young men and women to move our specialty forward, and to be able to outgrow their teachers and mentors and surpass them in their skills, because only such condition provides steady development. My dream came true. Many years later, as an experienced open access thoracic surgeon (making incisions smaller and smaller but still with retractors) I felt obliged to start anatomic videothoracoscopic resections. Believe me—it is not easy at the age of 50 but I was smart enough to reach the acceptable level of skills. Nevertheless, I still remained not completely comfortable with all those triangles, axes etc. Then, I met Diego again (knowing about his technique from medical literature of course) who—with his elegant, calm and delicate way—showed me all the secrets, tricks and shortcuts of the uniportal VATS. It was like enlightenment for me—experienced, traditional thoracic surgeon well accustomed to small but open thoracotomy. Suddenly, everything became clear and simple again—just mimicking open surgery, but performed in a modern and minimally invasive fashion.

As a result, I started to make my incisions even smaller (4 cm instead of 8–10 cm), stopped using retractors and began my uniportal VATS career at the age way above 50. Believe me, it works! Now, I stopped to count my uniportal VATS lobectomies, because I perform them regularly and I feel almost as comfortable as during open thoracotomy. I am pretty much convinced it would not be so easy without patient education by Diego.

He changed our thoracic world forever. I know that my feelings about this new technique are shared by many younger and older thoracic surgeons. Diego’s endless efforts to show his magic skills to the thoracic community, and to share his enormous knowledge about uniportal VATS are priceless and—despite his relatively young age—position him among the greatest giants of thoracic surgery.

Dear Diego Gonzalez Rivas, thank you for all you are doing for us. You are a great man, a great thoracic surgeon and—last but not least—a great friend.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Video-Assisted Thoracic Surgery. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/vats.2016.08.09). TG serves as an unpaid editorial board member of Video-Assisted Thoracic Surgery from Oct 2016 to May 2019.

This editorial is preface of the new book This is life: the journey of uniportal VATS.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.