We have always followed three maxims “come hell or high water”:
    The better technology, the better medicine.
    The more innovations, the more scientific and technical advances.
    The more knowledges and applications, the better service to our patients.

At the beginning of the 80s, when Russian made the first surgical equipment, called “auto wound suture equipment”, we adopted it and quickly learnt to use it in spite of its deficit, little or non – existent marketing and other specific problems, the only reason why we did it was that this equipment was marking the beginning of a new surgical age.

Around the middle of the 80s, we were already using new Laparoscopic approach equipment, with direct visual control and little or non – existent applied technology, but it let us perform a great many mini – invasive diagnostic process and even draw up novel treatments by Laparoscopy to treat diffuse peritonitis and severe pancreatitis.

At the beginning of the 90s, the approach via by Laparoscopy with an integrated camera and a new applied technology that soon would turn into the greatest surgical revolution in the world. In less than ten years, the market was supplied with digital cameras with three chips, images and all integrated systems, ultrasonic scalpels and vascular sealing ones, the most sophisticated laparoscopic surgical equipment, “intelligent” operating rooms, Telesurgery and Robotics applied to Endoscopic Surgery.

If we had already performed Laparoscopy in the Pre – laparoscopic age, with the new cameras and instrumental towers, our concept of “well indicated surgery” quickly focus on the axiom of “well indicated good laparoscopy”
 we gave up, without any possibility of returning, the classic and conventional open surgical procedures and resume a long and difficult learning to make possible that all surgical techniques, even although they were very complex, could be performed with mini – invasive methods, of laparoscopic approach, without incisions or post-operative pain, with a short stay in hospital and a quick return to usual daily activity.

Around 1995, almost all the surgical practice managed by our Team were especially performed by Laparoscopy, despite meaning a small “oasis” in the middle of a desert of lack of understanding and especially conventional practice. However, we faced a problem: There wasn’t yet any method to be able to operate Obese patients without having to open up.
In 1994, it was designed and introduced at first time a restrictive surgical procedure by Laparoscopy aimed at Morbid Obese patient: Adjustable Gastric Banding. We quickly went to the European Clinics that had begun to use it, and in 1995, we performed the first Gastric Banding operation by Laparoscopy in a Morbid Obese in Spain.

In 2000 we personally bought the Ultrasonic Laparoscopic technology that had just come on the market, and with the modern “endocutters” and last – generation Laparoscopic towers, let us perform the first Gastric Bypass especially by Laparoscopy such as “gold standard” to treat pathological Obesity.

In 2003, thanks to the advances in Robotics, we took a great (and risky) personal gamble on the New Technology at the service of the better treatment for the Obese patient, buying also the first (and only one at that moment) auxiliary Robot in Spain, and one of the first in the world. Also that’s why our Team is a pioneer with one of the highest experiences in Robotics in the world.

We have always said and maintained that the technology is the great ally of present – day surgeons. Surgeons committed themselves flat out to treat Obese patients must carry the necessary investments out in order to remain “on the crest of the wave”, learn the sophisticated handling of these new equipments anywhere in the world, apply them, share international experiences, be up to date with the scientific and technical information, publish their results in the greatest world impact magazines and mustn’t let slip the slightest opportunity to learn more day by day and apply their knowledge and experiences for life to achieve the main objective: to relieve or treat the patients that suffer from Obesity.

Miguel-A. Carbajo Caballero.
Manager of the International Centre for the Study and Treatment of the Obesity ( C.T.O. )