Marcin Barczyński1, Celeste Dai2, Margo Chen2
1Department of Endocrine Surgery, Third Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland; 2GS Editorial Office, AME Publishing Company
Correspondence to: Margo Chen. GS Editorial Office, AME Publishing Company. Email: editor@glandsurgery.org.
Editor’s note
Gland Surgery (GS) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year GS launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series “Novel Technologies in Endocrine Surgery” (1) led by Dr. Marcin Barczyński (Figure 1) from the Jagiellonian University Medical College has attracted many readers since its publication. This special series focuses on new techniques and technologies for the treatment of surgical endocrine diseases. The further development of novel technologies in the field will continuously challenge and modify our surgical practice in the forthcoming years warranting improved outcomes of surgery and quality of life for patients with surgical endocrine diseases. At this moment, we are honored to have an interview with Dr. Barczyński to share his scientific career experience and insights on this special series.
Figure 1 Prof. Marcin Barczyński
Expert introduction
Dr. Marcin Barczyński was trained in Poland, Germany and USA and has more than 25 years of experience in endocrine surgery, and surgical oncology. He is the Head of the Department of Endocrine Surgery and Full Professor of Surgery at the Jagiellonian University, Medical College, in Kraków, Poland. He serves as President of the European Society of Endocrine Surgeons (ESES), Councilor of the International Association of Endocrine Surgeons (IAES), Member at Large of the Council of the EUROCRINE Society, and a member the Steering Committee of the International Neural Monitoring Study Group (INMSG) for Thyroid and Parathyroid Surgery. Dr. Barczyński is the author of more than 220 peer-reviewed publications and book chapters. He has a citation count of 4651 and an h-index of 38. His work in improving surgical outcomes in endocrine surgical diseases has helped the medical field tailor and personalize treatment for patients with these conditions.
Interview
GS: What motivated you to specialize in the field of endocrine surgery? Or would you like to share a particular case or patient experience that influenced your decision to specialize in endocrine surgery?
Prof. Barczyński: Endocrine surgery is a specialized field that focuses on the surgical treatment of endocrine disorders. The most common endocrine disorders include thyroid nodules, thyroid cancer, hyperparathyroidism, adrenal tumors, and GEP-NETs. Endocrine surgeons have specialized training in the diagnosis and treatment of these conditions, and they work closely with endocrinologists, radiologists, and other specialists to provide comprehensive care for patients. The goal of endocrine surgery is to remove tumors or diseased glands while preserving the function of healthy glands and minimizing the risk of complications. Some of the factors that have motivated me at an early stage of my surgical career to specialize in endocrine surgery included a strong interest in the beauty of endocrine system influencing all aspects of human body, a desire to help patients with complex medical conditions, and a passion for surgical precision and innovation. In particular, advances in technology and imaging techniques which took place 20 years ago have made endocrine surgery safer and more effective, which attracted me as a surgeon interested in cutting-edge techniques and minimally invasive procedures.
GS: What are the current advances and benefits of novel technologies in endocrine surgery?
Prof. Barczyński: Current progress in endocrine surgery can be consider in several dimensions including improved preoperative workup, availability of alternative non-surgical treatment options for selected patients, widespread use of minimally invasive surgical approaches, development of tools for intraoperative quality control of surgery and advances leading to optimized patients’ pathways in the health care system (2). Nowadays there is no single surgical solution that fits all patients. Patients’ preferences are taken into account and personalized treatment can be offered according to the paradigm of precision medicine.
GS: What role do you think other novel technologies such as ChatGPT, 4D-CT scan and artificial intelligence will play in the future of endocrine surgery?
Prof. Barczyński: Novel technologies such as ChatGPT, 4D-CT scan, and artificial intelligence (AI) have the potential to significantly impact the field of endocrine surgery in the future. ChatGPT and other language models can assist endocrine surgeons in various ways. For example, ChatGPT can help answer questions related to patient care, provide guidance on surgical procedures, and help with post-operative care. These language models can also assist in medical education by providing access to a vast amount of medical literature and resources. 4D-CT scans can provide more detailed and accurate information about the location and size of endocrine tumors, allowing for more precise surgical planning. AI has the potential to revolutionize endocrine surgery by providing real-time data analysis during surgery, assisting surgeons in decision-making and improving surgical outcomes. AI algorithms can help identify abnormal tissue, assist in surgical planning and execution, and reduce the risk of complications. These novel technologies such as ChatGPT, 4D-CT scan, and artificial intelligence will likely play an increasingly important role in the future of endocrine surgery, providing surgeons with better tools to improve patient outcomes and quality of life.
GS: From your experience, what do you think are the biggest challenges in novel technologies in endocrine surgery, and how do you think these challenges can be overcome?
Prof. Barczyński: The greatest challenge for new technologies in endocrine surgery is the need to assess their clinical usefulness not only in prospective studies in expert centers, but also to ensure their availability in various countries and in various health care systems. In addition, the development of novel surgical tools, such as surgical robots, smart surgical instruments, and tissue engineering technologies, can further enhance surgical precision and reduce the risk of complications. Moreover, it is important to train surgeons in the use of these technologies so that they can be used optimally. Only ongoing training and education for surgeons and surgical teams can ensure that they are up to date on the latest surgical techniques and technologies, enabling them to provide the best possible care for their patients. These challenges can be overcome over time as the technology becomes more widespread, leading to lower per-patient costs.
GS: Have you recently conducted any research projects related to the topic of this series? If so, could you share some of your key findings?
Prof. Barczyński: Yes, I have just completed a RCT focused on evaluation of prevalence of recurrent laryngeal nerve (RLN) injury during bilateral thyroid surgeries using intermittent intraoperative neural monitoring (i-IONM) vs NerveTrend mode of the NIM Vital equipment. NerveTrend mode enables nerve condition tracking throughout a procedure, even when using i-IONM. After an initial probe stimulated EMG baseline trended readings at the same location on the nerve, NIM NerveTrend EMG reporting can enable comparisons of EMG amplitude and latency trends rela¬tive to the subsequent probe measurements manually captured throughout the case. A significant decrease in amplitude and/or increase in latency can signal degrada¬tion of the nerve condition. In addition, green, yellow and red color-coded EMG reporting and associated audible tones can help to understand when significant EMG changes occur and can help inform surgical strategy. Potential benefits of NIM NerveTrend mode are: no additional cost over i-IONM, it is easy to use, it provides almost real-time feedback, it tracks functional status of the nerve, it is a step forward in prognostic calculation of the EMG tracings, its intuitive display is easy to follow even during challenging operations.
GS: If given an opportunity to update this special series, what would you like to moderate, add or emphasize to provide a more informative and comprehensive series?
Prof. Barczyński: With every week, month and year, we have more and more research results on the use of modern technologies in endocrine surgery. Only the constant updating of this knowledge in accordance with the principles of evidence-based medicine allows it to be translated into clinical practice, turning it into the art of endocrine surgery.
References
- Novel Technologies in Endocrine Surgery. Available online: https://gs.amegroups.org/issue/view/933
- Barczyński M. Introduction to focused issue on novel technologies in endocrine surgery. Gland Surg 2020;9(Suppl 2):S65-S68.