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Printed in Austria

DOI 10.1007/s10353-011-0059-2© Springer-Verlag 2012

Editorial: Innovation and leadershipAndreas Shamiyeh

Ludwig Boltzmann Institute for Operative Laparoscopy, 2nd Department of Surgery, General Hospital Linz, Linz, Austria

A natural aim of surgeon’sbehaviour is to reduce theaccess trauma in surgicalpatients.

In the mid 1980s arevolutionary techniquewas introduced by the gy-naecologist Karl Semmper-forming an appendectomyand gained rapid accep-tance in thesurgeon’sworld[1]. A fewpioneers almost inEurope adopted this tech-nique for cholecystectomy.Philippe Mouret andJacques Perissat have been

the first performing laparoscopic cholecystectomy. Wolf-gang Wayand was the first surgeon in Austria performingdiagnostic video-laparoscopy in 1989 and cholecystectomyin March 1990. This was the start of a unique Austrianexperience. A register was founded and all laparoscopiccholecystectomiesandappendectomieswereregistered forthe first 4 years till 1994 from all clinics in Austria 100% [2].An update was done in 1998, and the registry was closed.Due to theeffortofmanysurgeonsover thecountry,Austriagainedpopularityasoneof the leading regions inEuropetillnow.The tradition is still continued:Single incisionsurgery,another step which might help to decrease the accesstrauma was introduced, and there is no country all overtheworld running a voluntary registry includingmore than3000 procedures, organized by the group of Helmut Weissand Walter Brunner in Salzburg.

Martin Riegler wrote in his Editorial “. . .EuropeanSurgery aims to deal with the spirit of time . . .majorpolitical and social changes. . .” [3] and I completelyagree! And I have to add on that we also have to dealwith the natural history of a lifetime career and thechange of generation.

Wolfgang Wayand is looking forward to retire soonafter a remarkable life as surgeon and head of the 2nd

Surgical Department in the General Hospital Linz, Aus-tria. He overtook the department in 1985 after his resi-dency at the surgical clinic of Vienna University and ashort time as vice chair in Salzburg. After a few years inLinz and the fast development of laparoscopy, he got incharge of the new founded Ludwig Boltzmann Institutefor Operative Laparoscopy in Linz in 1993 which is still inprogress. Under his leadership 4 surgeons achieved ha-bilitation andmore than 270 papers have been published.Highlighting his career, he got President of the EuropeanAssociation of Endoscopic Surgery from 2000 to 2003. Onhis way he was accompanied by many surgeons andfriends.

This issue of European Surgery is dedicated to Wolf-gangWayand and some of his friends were willing and feltproud to write an article honouring him for his lifetimework.

These articles deal with modern, progressive andestablished applications of laparoscopy. It is my personalpleasure as a 17 years lasting companion to announceAlbert Tuchmann and his team writing about a verychallenging procedure: The laparoscopic total gastrecto-my in gastric cancer shows that this operation can bedone safely following all oncological principles. It de-monstrates once again that Austria is the home of highlyadvanced laparoscopic surgeons. The second paper ofthis group demonstrates the intention to reduce theaccess trauma on step beyond traditional laparoscopy ininguinal hernia repair. Therefore it is exactly at the pointof time now – to deal with the reduction of the accesstrauma!

Roman Rieger, more than 10 years his deputy inLinz, one of the pioneers in laparoscopic sympathectomyworldwide reports in an outstanding paper about hisexperience over 306 operations for plantar hyperhidrosis,a procedure, which is still performed only in highlyspecialised centres.

Selman Uranus demonstrates in his article thatbowel obstruction – formally a contraindication forlaparoscopy – can be treated safely in the hands of anexperienced laparoscopic surgeon. He points out thatpatients’ selection is one of the most important strate-gies in surgery. And this leads me to one question whichevery surgeon should ask himself while thinking aboutthe next operation: If the patient is suitable for the

W. Wayand

Correspondence: Univ. Doz. Dr. Andreas Shamiyeh, Ludwig Boltz-mann Institut for Operative Laparoscopy, 2nd Department of Sur-gery, General Hospital Linz, Krankenhausstraße 9, 4020 Linz, Austria.Fax: þþ43-732-7806 2198E-mail: andreas.shamiyeh@akh.linz.at

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technique and if the technique is suitable for thesurgeon.

Rudolf Roka and his team are presenting theirtechnique and results of sleeve gastrectomy, anotherchallenging indication for modern minimal invasive sur-gery. As his clinic is known as a centre for goiter and upperGI malignancies, it is also established as one of the mostexperienced hospitals for bariatric surgery. This operati-on as well as the Y-Roux gastric bypass is a good examplethat surgery is still evolving. As this type of surgeryprimarily started to lose weight, it is now forced bygastroenterologists to treat diabetes. Lots of work willcome up for surgeons over the next years.

And as all started with laparoscopic cholecystecto-my, our group will honour him by presenting the resultsof his department in Linz from the very first laparoscopiccholecystectomy till now. As his personal wish, every LChas to be given a running number from the very beginningin 1990 in the “old fashioned none electronically ORBook” by hand. And maybe the children of the childrenof the children. . . will number. . .! However, over the lasttwo years cholecystectomies have been more often oper-ated transumbillically in single incision technique. Al-though Wayand is not convinced about this newtechnique and possible advantages for the patient, he letus perform this procedure in his generously style thinkingabout the difficulties he had to deal with when he startedwith laparoscopy, always with a clear outlook not to harmthe patient. Therefore it was always a conditio sine qua no

to collect the data and pay attention to the patient’soutcome.

Finally, one word about his way of leadership:Wolfgang Wayand proclaims it as academic privileges towork more than one has to. He always supported inno-vation and ambition. Over the last years it was his inten-tion to create a team with different characters havingsuccess in their field. And if one surgeon of his staffsurpassed him in some area he was proud to be a partof that success.

So this might be a take home message for modernleadership! Success starts with the team.

Therefore we have to say thank you for wonderfulyears and wish you, Wolfgang, all the best for the upcom-ing period.

Andreas Shamiyeh

Conflict of interest

The author declares that there is no conflict of interest.

References

[1] Semm K. Endoscopic appendectomy. Endoscopy 1983;15(2):59–64.

[2] Gitter T, Wayand W, Woisetschlager R. The status of laparo-scopic cholecystectomy in Austria. AMIC – Study Group forMinimally Invasive Surgery. Wien Klin Wochenschr 1995;107(2):61–4.

[3] Riegler M. It’s all about our academy. Eur Surg 2011;43(1):1–4.

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