Laparoscopy replaced incisional operations in gynecology

Žana Kovačević The Bosnian-Herzegovinian-American Academy for Science, Culture, and Art was recently founded in the USA, which gathers about a hundred very successful intellectuals from Bosnia and Herzegovina, including Dr. Rešad Pašić, internationally recognized leader of laparoscopic surgery, full professor of obstetrics and gynecology at the University of Louisville in Kentucky, and director of the Center for Minimally Invasive Surgery.

RSE: PROFESSOR PAŠIĆ, YOU HAVE BEEN VOTED ONE OF THE BEST DOCTORS IN THE USA FOR SEVERAL YEARS IN A ROW, AND THERE IS A LONG LIST OF AWARDS AND YOUR PROFESSIONAL SUCCESSES. BUT YOU WERE BORN IN SARAJEVO, WHERE YOU FINISHED YOUR EDUCATION. PROFESSOR PAŠIĆ, WHEN DID YOU GO TO THE USA AND WHY?

Pašić: In 1992, I happened to be in America, at a congress, and then I was forced to stay. Then I went all the way up, actually—I had to pass the nostrification exams. That's when I also started working here, at the university in Louisville. And that's how it all happened.

RSE: DOCTOR PAŠIĆ, WHAT ARE LAPAROSCOPIC AND MINIMALLY INVASIVE SURGERY?

Pašić: Laparoscopic and minimally invasive surgery is where surgery is performed without an incision. Today, all gynecological operations in the world, from simpler operations to complicated operations involving cancers, are performed laparoscopically. With the help of technology, we can introduce instruments into the organism through very small holes, then we attach a video camera, and we can practically perform operations while looking at the video screen, and thus we can operate. Today, all gynecological operations in the world, from simpler operations to complicated operations involving cancers, are performed laparoscopically. The advantage of this method is that there is virtually no incision, so patients recover much faster.

RSE: SINCE YOU ARE ALSO A PROFESSOR AT THE UNIVERSITY OF KENTUCKY, WHERE YOU LIVE, TELL US, HOW MUCH IS INVESTED IN SCIENCE AND EDUCATION IN THE USA?

Pašić: America invests a lot in education, in research, which is the most important thing, and at the same time, education is quite valued. Unfortunately, in Bosnia and Herzegovina and the entire area of the former Yugoslavia, science is quite devalued. Great efforts must be made to start valuing science more. I was recently in Sarajevo, and I was horrified when I heard that there is a quack there on Zetra, where people go, where thousands of people come to seek medicine instead of going to real doctors. Such things cannot happen in Western Europe or America. It is important to keep learning.

RSE: BEFORE OFFICIALLY GOING TO THE USA, YOU KNEW HOW THE SYSTEM WORKED, AND WHAT THE SOCIAL VALUES AND RELATIONS BETWEEN PEOPLE WERE. HOW DID YOU FIT IN, CONCERNING BH? TRADITION, BUT ALSO SOME RHYTHM OF LIFE?

Pašić: We recently founded the Bosnian-Herzegovinian-American Academy for Science, Culture, and Art. There we have about a hundred intellectuals from Bosnia and Herzegovina. And they are all very successful; I'm not the only one. As for "fitting in,"  there are clear rules of the game. If you follow the rules of the game and if you work hard, then success is guaranteed here. The most important thing is that a person works. Everything is possible to overcome. In the beginning, I studied a lot. Worked and studied at the same time. I had to pass those exams, so I worked eight hours a day and studied at least eight hours. This lasted for a year. Nothing is insurmountable. Of course, the most important thing is that you love what you do. The great advantage of America is that they, if they recognize quality, that someone wants to work, that he is talented, they force such a person, while in our regions, a young person can work very hard, and for political, maybe other reasons, they are once restrained everywhere. In my case, America got lucky.

RSE: PROFESSOR, YOU SPEAK QUITE MODESTLY ABOUT YOURSELF, BUT THE DATA SAY SOMETHING ELSE. FROM 2005 TO 2010 YOU WERE VOTED ONE OF THE BEST DOCTORS IN AMERICA, IN SUCH A GREAT COUNTRY.

Pašić: Yes, it is an organization that selects the best doctors in America, where your colleagues suggest certain doctors. Colleagues, in a way, choose you. Probably my biggest accomplishment is that I have been the president of the American Society of Gynecologic Laparoscopists for the past four years. It is an organization that has five thousand members worldwide. It's a very specialized organization, so I can probably say that it was the biggest achievement of my career that they chose me. When I first came to America, it was a distant dream; I could not even imagine that it could happen; however, thanks to persistent work—I published three books on endoscopy—then now I have the so-called fellowship where I lead a subspecialization in operative laparoscopy. I am currently chairing the Fellowship Board for All America this year.

RSE: YOU MENTIONED LEARNING, JUST LEARNING. ARE YOU STILL LEARNING?

Pašić: Absolutely! I am currently preparing a lecture on how it is. Now there are absolute conditions in Sarajevo, especially at the new Gynecology and Obstetrics Clinic; everything is functioning at a rather enviable level, if not better than in America. very important to learn, to train. I just found on the Internet a video of Maradona in training—all of them are walking, running a bit, warming up a bit, and he takes the ball and juggles it. It's just one small insert to show doctors how important it is that they have to train and study all their lives. Recently, I was at a congress with a doctor from Japan, who is, approximately, among the top five surgeons in the world. He was there with his wife. I told her, "You must be very proud of your husband because he is one of the top doctors in the world." She says, "Every morning when he gets up, he practices that laparoscopic sewing for fifteen minutes." That sewing is, by the way, a complicated operation. So, when I saw that the man who is probably the best in the world, according to some of my criteria, practices what he does every day, that was an additional incentive for me.

RSE: INDEED, SUPERIOR SUCCESS REQUIRES SUPERIOR EFFORTS. HOWEVER, LET ME ASK YOU: DO YOU SOMETIMES MISS BOSNIA AND HERZEGOVINA AND WHAT MEMORIES DO YOU CONNECT TO YOUR HOMELAND?

Pašić: We always miss him—I mean, all of us who are here. I am extremely happy that I have the opportunity to come to Bosnia and Herzegovina five or six times a year. At least three or four times. My mom and brother still live there. Now, at the beginning of April, I also plan to come to Sarajevo, to our newly opened Gynecology and Obstetrics Clinic, where we will do a course on this operative laparoscopy. I will bring two colleagues, Americans, who have achieved great success in the field of laparoscopy, and we will perform operations upstairs at the clinic. Now there are absolutely no conditions, especially at the new Gynecology and Obstetrics Clinic; everything works at a rather enviable level, if not better than here in America. Unfortunately, however, there is that old proverb that says, "It's not the cage that sings; it's the bird that sings." I am always at the service of doctors in Bosnia and Herzegovina, so it is only important that individual doctors become interested in it and then gradually seek education in it.