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Surgery has changed profoundly in recent decades due to advances in robotics , artificial intelligence and personalized therapies . A continuous exchange of knowledge is essential for surgeons to ensure medical care at the highest level. The University Hospital Mainz , with its high case numbers and state-of-the-art equipment, offers an ideal environment for comprehensive, structured and high-quality surgical training and further education. Prof. Grimminger promotes a culture of openness and collaboration in which every team member is valued as an equal partner. His approach of open knowledge exchange serves as a model for modern leadership in medicine. As part of my ESDE Fellowship, I benefit from the unique opportunity to learn from two leading surgeons: Prof. Grimminger in Mainz and Prof. Schneider in Zurich. With a lot of surgical exposure both at my previous location and now in Mainz, as well as active participation in scientific projects, this program offers an excellent environment to expand my expertise and develop my surgical skills. Of particular value is the weekly analysis of my progress by Prof. Schneider , which makes my learning process even more efficient and targeted. I incorporate new skills directly into my work at Hirslanden in Zurich.

The first month as an ESDE Fellow with Professor  Peter Grimminger at the   University Medical Center Mainz has passed, offering a moment for reflection and preliminary conclusions. After advancing my training in visceral surgery and beginning specialized training in esophageal surgery under the guidance of Prof. Schneider , embarking on a   fellowship at this stage in my career was a significant decision. However, following my initial internship with Prof. Grimminger  —made possible by the manufacturer post-training and after my first robot-assisted procedures with the Xi system—any reservations quickly dissipated. Being part of such an innovative team presents a unique opportunity for efficient personal and professional growth. In Mainz, five to seven complex upper gastrointestinal procedures are conducted weekly, predominantly with robotic assistance. I have been particularly impressed by the diversity of these procedures, ranging from double-tract reconstructions using the Da Vinci Xi system to transcervical, robot-assisted esophagectomies with the single-port system (Da Vinci SP). Notably, some cases involve dual-team approaches, enabling simultaneous transcervical and transabdominal preparation. Equally compelling are the numerous technical refinements Prof. Grimminger   and his team employ, which contribute to making these challenging procedures both safer and more efficient. In these initial four weeks in Mainz, I have already gained substantial experience and insight. One of the most valuable takeaways has been identifying specific technical skills I wish to prioritize and incorporate into my practice in Zurich as soon as possible. Beyond surgical involvement, I am actively participating in several research projects, which is helping me pursue and further my scientific objectives. This fellowship year holds the promise of being exceptionally stimulating, and I am genuinely looking forward to the journey ahead!

From October 1, 2024, I will start my fellowship at the University Hospital Mainz, Germany, with Prof. Grimminger in the field of “Minimally Invasive Esophagectomy (MIO)”. Many thanks go to Prof. Dr. med. Paul Magnus Schneider and the ESDE selection committee for their trust in my abilities and support of my professional career. I am looking forward to an intensive year full of new insights and to working with outstanding experts in this field.

After six months of intensive efforts, I received, just in time, the license certificate necessary to begin scientific work at the University Medical Center in Mainz. After six months of intensive efforts, I received my license to practice medicine just in time, which is necessary for me to take up scientific work at the University Medical Center in Mainz. This means that nothing stands in the way of me starting my ESDE-funded further training. In Switzerland, my professional environment occasionally discusses how challenging it is, especially for German assistant doctors, to find employment in Switzerland and fulfill the necessary requirements for obtaining a professional license. However, one thing has now become clear to me: The requirements for obtaining a professional license in Germany are no less demanding for a Swiss doctor! As an Italian-Swiss dual citizen who completed the majority of her medical training in Italy, my diplomas obtained in Italy were recognized without the need for a special examination . However, foreign doctors must also pass a specialist language test at C1 level in order to obtain a license to practice medicine in Germany.I took this exam at FaMed and traveled from Zurich to Mainz especially for it. One of the tasks there was to act out a consultation with a patient in front of the camera, with extras acting as interlocutors. Another unexpectedly complicated aspect was obtaining the necessary official certificate of good conduct. This process took four months and required a lot of patience, but little money: I had to pay EUR 13 for it. I have now rented an apartment in Mainz and plan to move around locally mainly on foot or by bike. I'm really looking forward to the professional and personal challenges ahead with Prof. Peter Grimminger in Mainz!

Last week, I had the opportunity to participate in a training session with Dexter on a model. My special thanks go to Professor Schneider, who contributed his extensive expertise during the training, and to Distal Motion, the manufacturer of this system, without whose support this would not have been possible. While I worked on a fictitious part of an anastomosis, Dexter transformed my hand movements into precise and controlled micro-movements. This capability of the robotic system enhances movement accuracy and control, which is particularly advantageous in the more complex parts of a procedure. The training allowed me to develop my manual skills further in using a surgical robot, which is valuable preparation for my upcoming tasks in Mainz with Professor Grimminger and will undoubtedly benefit me.

With this qualification I expand my skills in minimally invasive and robot-assisted surgery. The curriculum covered the application, components and operating modes of the system as well as practical exercises on operation in realistic scenarios.

I am pleased to present our recently published paper on prophylactic endoluminal vacuum therapy (eVAC) in surgical ampullectomies. In this study, we demonstrated that the combination of eVAC and continuous periduodenal irrigation (CPI) further reduces the risk of complications in these gentle but very demanding procedures. A big thank you to all contributors for their valuable support and cooperation. Dr. Olga Meier Link to publication: Langenbeck's Archives of Surgery (2024) 409:220

I am very pleased to announce that I have successfully completed the da Vinci Technology Training and am now certified as a console surgeon by the manufacturer . This certification confirms my ability to master the components and use of the state-of-the-art da Vinci Xi system , which is one of the most advanced platforms for minimally invasive surgery. Thanks also to Prof. Paul Magnus Schneider , who supported me a lot during this phase of my training. The training took place at Intuitive's RAIN Robotic Academy in Naples and was conducted under the direction of Filippo Polleri . During the program, I learned how to use the instruments, accessories and software of the da Vinci system, which allows me to perform precise and patient-friendly surgical procedures. Da Vinci technology is revolutionizing surgery by providing surgeons with unprecedented precision and control. Through this certification, I am now able to use this technology in my daily practice to provide my patients with the best possible access to minimally invasive procedures. With this new qualification, I will further expand my knowledge and skills in the field of surgical robotics and look forward to using this advanced system in future procedures. This knowledge will also be helpful to me during my fellowship in Main with Prof. Peter Grimminger .