Figure 1 Dr. Erik R. de Loos

Interview

MED: What inspired you to focus your research on minimally invasive thoracic surgery?

Dr. de Loos: As a general thoracic surgeon, I am deeply committed to all aspects of my field. In recent years, minimally invasive surgical techniques have become increasingly important, which has allowed us greatly to improve patient outcomes. It is crucial to scientifically validate these results and share them with colleagues all over the world. Our research team strives to make a meaningful contribution to this effort every day.

MED: Can you discuss the advancements and challenges you have encountered in minimally invasive thoracic surgery, particularly with uniportal video-assisted thoracic surgery (VATS)?

Dr. de Loos: At my institution, we have used uniportal VATS as the standard approach for both simple and complex thoracic procedures for over 10 years. This minimally invasive technique offers better visualization and causes less tissue damage, benefiting our patients. However, the introduction of new techniques inevitably comes with a learning curve for both the surgeon and the surgical team. It also calls for a new approach to training young colleagues. In recent years, our team has been highly active in training surgeons from various countries, and as faculty members, we regularly participate in courses on minimally invasive thoracic surgery throughout the year.

MED: How has your research in chest wall pathologies, such as oncology, trauma, and pectus deformities, influenced clinical practice at Zuyderland Medical Center?

Dr. de Loos: Through research on chest wall disorders and a critical review of our own outcomes, we have significantly improved the quality of patient care over the years. This focus has also enhanced the visibility of our center and greatly expanded our international network. As a result, our tertiary referral center for chest wall disorders has experienced substantial growth in several key areas.

MED: What motivated you to focus on perioperative care in your research, and what impact has this had on patient outcomes in thoracic surgery?

Dr. de Loos: By focusing on perioperative care, we have been able to enhance care pathways, such as implementing advanced chest tube management and Enhanced Recovery After Surgery (ERAS) protocols. This reduces complication rates and length of hospital stay and improves patient satisfaction.

MED: As vice-chair of the general surgical training program and chair of the thoracic surgical training program, how do you approach the mentorship and development of surgical trainees?

Dr. de Loos: Training the next generation is a great privilege, and it also keeps us as mentors sharp and up to date. Creating a safe and supportive training environment is essential. I truly enjoy watching our residents develop their surgical, clinical, and scientific skills.

MED: Can you share your experiences and contributions as a board member of the Chest Wall International Group (CWIG)? How does CWIG impact the global approach to chest wall surgery?

Dr. de Loos: The Chest Wall International Group (CWIG) is the largest global association dedicated to chest wall pathology. In addition to congenital (pectus) deformities, there is a strong focus on chest wall trauma, chest wall resections, and subsequent reconstruction for malignant conditions such as sarcoma. Thoracic and pediatric surgeons from all over the world collaborate to improve care for these patient groups. Several joint scientific projects are carried out and are presented during the CWIG annual meeting. I am very proud to serve as a CWIG executive board member and to work alongside some of the world's leading chest wall surgeons. I would especially like to advise every interested healthcare provider to become a member of CWIG, additional information via https://www.cwig.info.

MED: What do you see as the next major innovation in minimally invasive thoracic surgery, and how are you preparing for it in your research and practice?

Dr. de Loos: I believe that the introduction of specialized robots for thoracic surgery will be the next major innovation in minimally invasive techniques. With uniportal robotic-assisted thoracic surgery (RATS), we can perform surgeries with even greater precision and less tissue damage. Within the field of chest wall surgery, the expanded use of cryo nerve blocks will significantly improve recovery outcomes, reduce pain scores, and minimize morphine use for our pectus patients. Finally, the growing trend toward centralizing complex surgeries will further enhance the quality of care we can provide. 

MED: How has your experience been as an Editorial Board Member of MED?

Dr. de Loos: I am honored to serve as a member of the Editorial Board of Mediastinum. Overall, my experience with the AME Group and its journals has been very positive. The quality of the articles published is exceptional, and the support from the editorial offices has been both efficient and pleasant. Together, we have the opportunity to elevate the thoracic research community to new heights!

MED: As an Editorial Board Member, what are your expectations for MED?