Every career has defining moments. For me, one of those moments arrived before I had even entered my surgical residency. It happened during my internship.
At that time, minimally invasive surgery was in its infancy. Laparoscopic surgery was so new that most surgeons in Mexico — and virtually all of Latin America — had never even seen a laparoscopic tower, much less performed an operation using one. As I remember it, there were only three laparoscopic towers in the entire country.
El Pelochas
One of them was purchased by a remarkable surgeon who would profoundly influence the course of my career: Dr. Rojas Pineda. To everyone who knew him, he was affectionately known as 'El Pelochas.'
He served as the Director of a public hospital and was recognized as one of the most talented and visionary surgeons in Mexico. Unlike many surgeons who waited for innovation to become accepted, Dr. Rojas Pineda believed that the future belonged to those willing to learn before everyone else.
I was fortunate enough to be there at exactly the right moment.
The animal laboratory
As an intern, I joined the team that was beginning to explore laparoscopic surgery. There were no established residency programs. No simulation laboratories. No online videos. No formal curricula. We learned the only way possible. We built the future ourselves.
Our laboratory was an animal laboratory using porcine models. Before any surgeon could perform these revolutionary operations on patients, they first had to learn on pigs. As the youngest member of the team, my responsibilities were simple but essential. I prepared the animal models. I washed them. I helped anesthetize them. I prepared the operating room. I observed everything.
I watched some of the finest surgeons in Mexico struggle with an entirely new way of operating. Everything they had mastered through open surgery suddenly had to be relearned while looking at a two-dimensional monitor. Depth perception changed. Hand movements changed. Visualization changed.
Unlike many experienced surgeons who first had to unlearn decades of habits, I was learning laparoscopy almost from the beginning of my surgical career. I had no old habits to overcome. To me, laparoscopic surgery simply felt natural.
From learning to improving
As our experience grew, something remarkable happened. We stopped simply learning laparoscopy. We began improving it.
One of the first concepts we questioned was the traditional role of the camera assistant. In the earliest days of laparoscopy, one surgeon operated while another individual held and directed the camera. We quickly realized that this arrangement limited efficiency and precision. Working together, we helped develop a different approach that allowed the operating surgeon to work with both hands while maintaining stable visualization. It seems obvious today. At that time, it represented a meaningful evolution in surgical ergonomics.
Innovation did not stop there. Many of the specialized laparoscopic instruments that surgeons take for granted today simply did not exist. If we needed a better instrument, we designed one. We worked directly with manufacturers to create equipment that would make operations safer, more efficient, and technically easier to perform.
Technology should never dictate patient care. Technology should evolve to serve patient care.
From student to teacher
When my internship ended and I entered my General Surgery residency, I arrived with an experience unlike that of most young surgeons. I was no longer simply learning surgery. I had already participated in helping pioneer an entirely new surgical discipline.
By the completion of my residency, I had performed and published a series of approximately one thousand hernia repairs, contributing valuable clinical experience to the growing body of laparoscopic literature.
Immediately after graduating from residency, I was invited to become a Professor in Basic and Advanced Laparoscopic Surgery. The transition happened almost immediately. One day I was completing residency. The next I was standing at the front of the classroom teaching practicing surgeons.
Soon afterward, I expanded my educational activities internationally — advanced laparoscopic training programs in Seattle and later in Durham, North Carolina, working alongside Dr. López Corvala as co-director and faculty member.
Those years confirmed something that would remain true throughout my career. I loved operating, but I loved teaching almost as much. Teaching multiplies impact. One successful operation changes one life. Teaching one surgeon changes thousands.