What motivates leading surgeons to excel in work and in life? Leading cerebrovascular and skull base neurosurgeon shares his passion and dedication. Dr. Philip Theodosopoulos is following the path of Andreas Vesalius and Leonardo da Vinci. Professor Philip Theodosopoulos meticulously studies surgical microanatomy of skull base. He uses modern methods of CT scans to better understand every nuance of skull base anatomy. "Surgeons mostly see normal anatomy when they operate on patients. Normal anatomy can reduce a great surgeon to mediocre surgeon”. "To be a superior surgeon, you have to go back to basic building blocks of anatomy.” "In 84 dry human skulls imaging studies were performed by 64-slice computed tomography.” What motivates leading surgeons? Dr. Anton Titov, MD. What drives a highly skilled surgeon to continue study dissection anatomy of skull? Dr. Philip Theodosopoulos, MD. Video interview with leading expert in skull base neurosurgery. Microsurgical anatomy of skull is necessary to improve surgical skill. Surgeons mostly see normal anatomy when they operate on patients. Normal anatomy can reduce great surgeon to mediocre surgeon. Medical Second Opinion from leading surgeon can confirm tumor diagnosis. Medical Second Opinion also helps to choose the best treatment for cancer or benign brain tumor. Dr. Anton Titov, MD. Seek medical second opinion on brain tumor and be confident that your treatment happens according to leading international standards. Dr. Philip Theodosopoulos, MD. Surgeons can only become better by more experience. But operating on patients is not sufficient. Surgeon has to continuously study dissection anatomy in his speciality. Neurosurgeon has to study brain anatomy on cadaveric heads. To become great surgeon, to push the envelope surgeon really has to go back to basic building blocks of microsurgical dissection anatomy. What motivates leading surgeons. Becoming best surgeon. Dr. Anton Titov, MD. You have a particular interest in the delicate and very complex anatomy of skull base. You prolifically publish this fascinating surgical anatomy research. Let me quote some titles from your 6 recent papers about the surgical anatomy of neurovascular skull base structures. Endoscopic, endonasal variability in the anatomy of internal carotid artery. Anatomic variation of the optic strut: classification schema, radiologic evaluation surgical relevance. Dr. Anton Titov, MD. Anatomy of the inferior orbital fissure implications for endoscopic cranial base surgery. Anatomic study of the prechiasmatic nucleus and its surgical implications. Dr. Philip Theodosopoulos, MD. Anatomy of the optic canal: a computed tomography study of endoscopic nerve decompression. Endoscopic anatomy of the petrous segment of the internal carotid artery. Let me also quote some methods that you use in some of these studies: "In 84 dry human skulls imaging studies were performed by 64-slice computed tomography." Endoscopic endonasal dissections were performed in 6 formalin-fixed cadaver heads. Morphometric analysis of 100 skulls was conducted using CT scans and the Brain Lab. 4 patients underwent procedures that exposed the maxillary strut. In 10 cadaveric specimens microanatomical and endoscopic dissections were performed. Dr. Philip Theodosopoulos, MD. Dissections were done via approaches in the middle turbinate and the inferior turbinate. Dissections were performed also via the Caldwell-Luc treatment through the maxillary sinus. these quotes from your work and your studies vividly demonstrate the degree of dedication. They show the need for continuous honing of surgical skills. They also show your understanding of very specific and delicate surgical anatomy. Dr. Philip Theodosopoulos, MD. Such technical skills are required for a surgeon who wishes to have a world-level excellence in his field. Not many surgeons today are literally following the steps Leonardo da Vinci. Not many surgeons do their own anatomical research today. Dr. Anton Titov, MD. What drives you in these rigorous pursuits? How does it help you in your clinical practice? Dr. Philip Theodosopoulos, MD (Neurosurgeon, Director of Skull Base Tumor Program, UCSF). You know, it is interesting. Microsurgical anatomy has been my primary interest in research. My other interest is clinical outcomes research. Dr. Philip Theodosopoulos, MD. Medicine may have started with Hippocrates and Galen. But surgery really started with Andreas Vesalius and patients in the Middle Ages and Renaissance. In Renaissance they actually took the interest in dissecting the human body. It is the only method how surgeons can really stay grounded in what is important in surgery. Dr. Philip Theodosopoulos, MD. We need understanding that even the most experienced surgeons are reduced to mediocre surgeons so often by the normal anatomy that we encounter. It goes without saying that for a surgeon to be good, surgeon has to really study a lot. Dr. Anton Titov, MD. The studying doesn't come only from the patients you see. Because there is just no method that you can see this many patients or do this many surgeries. to some degree it ends up being a human experimentation. Sometimes you are not good at what you are devising. All of these new techniques that we have. Dr. Philip Theodosopoulos, MD. Sometimes you take the new techniques straight to the patient instead of having done that many many times in cadaveric material. Or you practiced new techniques in a simulated environment. You are not able to say that we are safe to perform new surgical technique on a patient. That is what we see in this anatomic work. We see that we can only become better surgeons by experience. If you want to push the envelope you really have to go back to basics of surgical methods. Dr. Philip Theodosopoulos, MD. You have to go back to the basic building blocks of anatomy. You have to understand anatomy very well. You have to understand the relationships between anatomical structures. Most recent work we have done is focusing on the endoscopic methods to treatment the skull base. Skull base that we have seen thousands of times from the leading. Skull base that we see from the subcranial area. It looks so different when you come from below. It is the same anatomy. Anatomy doesn't change the method we come from below, from the leading, or from the side. You have to study and understand the limitations, relationships et cetera from the specific treatment that you are having. Dr. Philip Theodosopoulos, MD. Only then you are not going to be good. You are not going to understand the limits. You are not going to understand the risks you are taking. then you are going to be sub-optimal in your surgical skills. In training it is crucial for all of us. It is not only crucial in training our surgical residents or fellows. Dr. Anton Titov, MD. But in training ourselves, in training all of us, it is imperative that we have to do that. We have to study surgical anatomy continuously and rigorously. What motivates leading surgeons? How to achieve leading surgical skills? Video interview with leading expert in skull base neurosurgery. Surgical excellence and anatomy.