Dear Hernia friends,
My name is Gianluca Piccirillo, I am a general surgeon at ULSS9 “Scaligera” in San Bonifacio hospital near Verona. I have been working in abdominal wall surgery for about 4 years now, we have recently created a specialized clinic with the aim of improving the overall procedure for hernia patients starting from the pre-operative phase of preoptimization to surgical intervention up to the follow up.
I personally believe that the modern way of training has to be based on multi-center internships, allowing us to see several different ways of working as well as obtaining knowledge from a variety of experienced surgeons, particularly for a field of surgery in full evolution such as that of abdominal wall surgery.
I would like to thank EHS for the opportunity that was given to me. During the two weeks from November 14 to November 25, 2022 I had the honor to visit one of the best surgical centers in Europe under the supervision of Prof. Miguel Angel Garcia Urena.
During my time in Madrid I had the chance to see a large number of surgical interventions. I had the opportunity to see and learn tips and tricks of the Madrid TAR”, to see a very fascinating intervention never seen live before, the “Pauli procedure” for a complex midline and parastomal incisional hernia, to see a hybrid approach for lateral hernias. I was also like to see a very interesting mini-invasive procedure, the e-Tep ventral hernia repair. I’m convinced that over time this procedure will become the minimally invasive reference procedure for the abdominal wall surgery.
I would like to give a special thanks to Prof. M.A. Garcia Urena, I can’t emphasize enough how professional he is and how highly skilled he is. In this letter I would like to underline his kindness, his ability to teach in a relaxed and friendly manner. He never once made me feel like a foreigner during my time in the hospital.
During my time in Madrid I had also the chance to know two other great surgeons: Prof. Luis Blazquez and Prof. Javier Lopez-Monclus, I would like to thank them for the time they have dedicated to me and for all the tips and tricks they taught me.
Three are the my “take home message” from this experience:
1) To do the best abdominal wall surgery requires a profound knowledge of anatomy
2) To avoid recurrences it’s necessary to place large meshes with ample overlap
3) The extraperitoneal space is the best place for meshes placement (the IPOM technique should be reserved for only a select few cases)
Finally, it was an amazing experience, the EHS travel grant gives surgeons the chance to meet new colleagues in European surgical centers of excellence, to obtain knowledge about various surgical techniques in a field such as that of hernia surgery in continuous evolution.
I hope to be able to visit other surgical centers and step by step obtain the UEMS AWS diploma in the future.
Thank you EHS,