Menthorship

In 2019, Professor Elvira Bratila initiated in Romania the mentorship programme entitled “Inspiris Mentorship Program”

Conceived under the slogan “Discover, inspire, aspire”, our programme offers a structured framework, where learning experiences take place by the confrontation with a diversified caseload, patients with complex gynaecological conditions, in order to assimilate the knowledge and abilities required to create the premises for developing and making the most appropriate medical decisions for our patients.

Our team, made up of physicians ultraqualified in minimally invasive laparoscopic or robotic surgery, makes available for the medical community a  professional database, information, and video content, of some complex interventions in the field of endometriosis surgery, of the onco-gynaecological pathology, of pelvic static disorders and other gynaecological conditions addressed by surgery.

Our mission-vision

What is the vision of the mentorship programme?

• Mentorship in surgery means constant exposure of the specialists to cutting-edge surgical techniques

Being the first gynaecology surgeon who carried out gynaecological interventions by robotic surgery by using the da Vinci platform, we can say that the training and the super specialisation in this new technique is not simple at all,  it is a combination of theory, practice, and a lot of vision on the integration of the previous practice, achieved in years of classical vaginal and laparoscopic surgery.

Robotic surgery came as an alternative to the conventional laparoscopic surgery, meant to exceed certain limitations related to the perception of depth or the minute dissection imposed by oncology or endometriosis cases in advances stages and other types of interventions in serious cases, difficult to solve by a classical or laparoscopic procedure.

In point of choosing a surgical technique, today we approach ever more difficult cases with the da Vinci robot: cases of deep endometriosis, cervical cancer, endometrium cancer in patients with morbid obesity, large-sized fibroids s.o.

• The minimally invasive surgery of deep endometriosis required constant training and specific surgical abilities, developed within a multidisciplinary team

Unlike other pathologies, in endometriosis one cannot state that “endometriosis surgery was initially performed the classical way”, because the most important progresses in endometriosis surgery were achieved by the minimally invasive approach proper.

From diagnosis, when the laparoscopic approach allowed for the identification and localisation of the endometriosis lesions up to the surgical treatment of the disease, all advantages were due to technology and minimally invasive techniques.

As the use of laparoscopic surgery took off, the prevalence of endometriosis was reported in increasing percentages precisely because this type of approach allowed the diagnosis of the disease in many women who suffered long years of chronic pelvic pain or were classified as infertile without knowing the cause.

What should be emphasized to all specialists is that the first surgical approach to endometriosis is a gesture of great responsibility for the surgeon, because the decision of the surgeon operating on endometriosis must take into account a whole horizon of factors, which achieve a complete excision of endometriosis lesions, pursuing a balance and a therapeutic balance in 3 stages: pre-surgical, during the intervention and post-intervention.

Moreover, we do not aim at a punctual goal, but the endometriosis horizon aims at short-medium-long term goals. If we refer to the woman suffering from infertility, for example, the surgery can be a supportive surgery in an assisted human reproduction procedure. Therefore, surgery for endometriosis requires a view of the whole clinical context and the therapeutic goals established with the patient.

In terms of painful symptoms, impact on the fertility of the affected woman and recurrence of the disease, endometriosis surgery is more than a niche surgery, it is a complex, territorial surgery requiring expertise and constantly trained surgical skills.

• Mentoring aims at a learning-adaptation process to current changing medical paradigms

Changing paradigms regarding the biology of neoplastic disease, for example, detection at earlier and earlier stages, confirmation of the efficacy of new cancer treatments and, not least, the increasingly active involvement of patients in the therapeutic decision and the concern for a better quality of life post-surgery, have been strong arguments for the evolution of cancer surgery.

Having gone through all types of surgery, from the classical, vaginal and hybrid routes, an experienced surgeon assimilates all this experience to understand the advantages of each method, but above all their limitations. In cancer surgery, radical surgery was conceptually based on the theory of the orderly, close-up spread of cancer, but over time the advantages of the method have been outweighed by its limitations.

Benefiting from new scientific and theological advances, we have become familiar with the new standard, which today is minimally invasive surgery. The sentinel lymph node technique is now a standard in the surgical treatment of mammary gland cancer and is also commonly used for the treatment of cervical and endometrial cancer, vulvar neoplasm and penile neoplasm.

• Mentoring boldly rewrites new paths and sets a new level of aspiration

Based on this idea, we have opened a new path in Romania, which we want to inspire: urogynaecology, as a frontier specialty that deals with the diagnosis and treatment of pelvic static disorders. Our team is continuously concerned with the implementation of the newest and most effective diagnostic methods in the treatment of urinary incontinence and prolapse, using conventional surgical techniques, which use the body’s own tissues for reconstruction, as well as prosthetic techniques with materials accepted by the human body. The success rate of the techniques we use is more than 90% for incontinence and prolapse treated for the first time.