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Professor Evgeni Kolesnikov
A surgeon must learn throughout life
Professor Kolesnikov about pioneering in laparoscopic operations on the pancreas, creating the world "gold standard" in bariatric surgery and stem cell therapy.
Professor Evgeni Kolesnikov
MD, PhD, DMedSc, FICS, FIMSA
Surgeon of the highest category, Professor at the Department of General and Emergency Surgery in P. L. Shupik National Academy of Postgraduate Medical Education, Professor at the Kyiv Medical University (teaching surgery in English), Doctor of Medicine, Member and Professor at Harvard Medical School, Postgraduate Association (USA), the Vice President of Ukrainian Association of Plastic Reconstructive and Aesthetic Surgeons, Member of the American Academy of Cosmetic Surgery, Member and Prize and Medal Holder of the International College of Surgeons (USA) and of the State Prize of Ukraine, Member of the International Medical Sciences Academy (IMSA), a lead surgeon at the Deva Clinique.
Professor Evgeni Kolesnikov is full of strength and energy to successfully perform complex hours-long operations. With his own example, Dr. Kolesnikov proves that Ukraine has some of the leading scientists in global surgery too. After all, Dr. Kolesnikov is not only an outstanding surgeon and a laureate of a vast range of awards, but also a co-author of the world "gold standard" in morbid obesity surgery (developed together with his American colleagues D. Halmi and O. Anez).
By just glancing at the doctor's business card it is easy to find out a shortage of space on it for all his achievements. For many years, the professor has worked in the United States of America and now continues to operate and instruct young Ukrainian surgeons on American technologies. Dr. Kolesnikov comes to the interview with three huge albums containing photographs with colleagues in different countries, images of awards and medals.
By just glancing at the doctor's business card it is easy to find out a shortage of space on it for all his achievements. For many years, the professor has worked in the United States of America and now continues to operate and instruct young Ukrainian surgeons on American technologies. Dr. Kolesnikov comes to the interview with three huge albums containing photographs with colleagues in different countries, images of awards and medals.
Despite the variety of diplomas in the office, Dr. Kolesnikov never stops studying: every several years he visits Harvard University and takes advanced courses there to share innovative western technologies with his students. Professor is convinced that a surgeon must learn throughout life.
How Ukrainian specialists influenced the development of surgery all over the world, what is the "gold standard" and what problems plastic surgery can solve — read further on ONLINE.UA.
How Ukrainian specialists influenced the development of surgery all over the world, what is the "gold standard" and what problems plastic surgery can solve — read further on ONLINE.UA.
1
On the formation of a career: legendary teachers and a world-scale discovery
Evgeni Kolesnikov recalls the beginning of his way under good leadership. It all began with a studentship at Odesa National Medical University, where Evgeni Kolesnikov became the winner of republican scientific competitions for two times. Soon after graduation, he got a job with Academician Oleksandr Shalimov, who opened the Research Institute of Clinical and Experimental Surgery (Ukraine) and attracted young doctors to work together.
In the early 80s, Evgeni Kolesnikov defended his Ph.D. thesis, where for the first time the results of the development and implementation of new surgical interventions in combination with sorption methods of detoxification were reflected. His research turned out to be pioneering in this branch not only in our state, but also far beyond its borders. For the first time, special sorbents, methods and portable devices to extract toxins from blood and lymph were created.
In the early 80s, Evgeni Kolesnikov defended his Ph.D. thesis, where for the first time the results of the development and implementation of new surgical interventions in combination with sorption methods of detoxification were reflected. His research turned out to be pioneering in this branch not only in our state, but also far beyond its borders. For the first time, special sorbents, methods and portable devices to extract toxins from blood and lymph were created.
In 1985, the world's first monograph on the application of these methods in clinical surgery was published. In 1986, Kolesnikov was awarded with the State Prize of Ukraine for the development, theoretical justification and clinical implementation of innovative methods of surgical treatment, detoxification and rehabilitation of patients with liver and bile ducts diseases.
At the same time, the laparoscopic technique began to be introduced into the world surgery (the author: it is a method when operations on internal organs are performed with a help of a laparoscope through some small holes), and Evgeni Kolesnikov started to use it in his practice. He recalls that the surgeons performed the first laparoscopic operations on the pancreas in acute pancreatitis extremely delicately. They did not know that they were the only ones in the world to tackle this pathology:
At the same time, the laparoscopic technique began to be introduced into the world surgery (the author: it is a method when operations on internal organs are performed with a help of a laparoscope through some small holes), and Evgeni Kolesnikov started to use it in his practice. He recalls that the surgeons performed the first laparoscopic operations on the pancreas in acute pancreatitis extremely delicately. They did not know that they were the only ones in the world to tackle this pathology:
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This was the first time in the world in the early 80s of the last century, and we did not know about that. We announced our pioneering researchers in that area later. The first short article about this was published in 1985 in the journal Clinical Surgery. At that time, to declare in the international medical press was a difficult task, because the USSR labeled all works of great importance as "Not for public use". So, this label was put on both the article and my doctoral dissertation. And only many years later we could talk about that.
My last report on this was presented at the World Congress of the International Medical Science Academy (2018) at the Royal College of Physicians and Surgeons of Glasgow (UK). I gave two reports, one of which declared that Ukraine was the first to begin these studies in world history.
My last report on this was presented at the World Congress of the International Medical Science Academy (2018) at the Royal College of Physicians and Surgeons of Glasgow (UK). I gave two reports, one of which declared that Ukraine was the first to begin these studies in world history.
Foreign scientists were strongly interested in these materials. A surgeon from Germany wanted to get acquainted with this technology himself and share it with his team. Thus, Dr. Kolesnikov was invited to Germany to share his techniques, where in sum he spent one year. Then, from Germany he was invited to the USA.
Dr. Evgeni Kolesnikov
On the formation of a career: legendary teachers and a world-scale discovery
2
"Gold standard" and the American obesity pandemic
Evgeni Kolesnikov was invited to Harvard University, worked in leading American clinics, and completed some training programs in the United States healthcare system. In three years Dr. Kolesnikov moved from Boston to Washington, where he began working with morbid obesity — in bariatric surgery (author: operations aimed at treating obesity with a surgical method).
The professor says that America in the early 2000s had a real obesity epidemic: people, who were ought to be operated, abounded everywhere. Various methods of surgery to treat obesity, both upfront and, later, laparoscopic existed. Upfront operations were performed through an incision of 25-30 cm and often led to infecting surgical wounds, purulent-necrotic complications, large hernias, and prolonged hospitalization.
The professor says that America in the early 2000s had a real obesity epidemic: people, who were ought to be operated, abounded everywhere. Various methods of surgery to treat obesity, both upfront and, later, laparoscopic existed. Upfront operations were performed through an incision of 25-30 cm and often led to infecting surgical wounds, purulent-necrotic complications, large hernias, and prolonged hospitalization.
Laparoscopic operations were time consuming, with a high percentage of intra-abdominal complications. They also were more expensive and not always possible. Therefore, together with my American colleagues (D. Halmi and O. Anez), we have developed a Mini-open Roux-en-Y Gastric Bypass operation method (gastrojejunal shunt procedure through a mini-laparotomic access (only 7-8 cm), which is performed quickly (less than 1 hour), with a minimum number of complications, quick rehabilitation and less time to master the method. It became the "gold standard" in global surgery. The "gold standard" method allowed not to make 25-30 cm incisions during the operation, as it was before:
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What does the "gold standard" mean? The method includes two main components: restrictive, that does not allow to eat a lot, since a large stomach transforms into a small one, which can hold only small portions of food. In addition, besides the rest of the stomach, a part of the small intestine (about 1.5 m) is amputated from digestion and, thus, a person eats less to absorb less nutrients. Due to this, a person loses weight. Such an operation is less invasive and less traumatic.
In 2004, as the inventors of the method, we reported at the World Congress of the International College of Surgeons in Ecuador, the World Congress of Surgeons in Tokyo, and the European Congress in Prague. In the years to follow, we tried to travel all over the world and show this method in various countries. From five to six times a year we spoke at different global and European congresses, demonstrating our method and excellent outcomes of operations. As for now, this method is widely used in world surgery to fight morbid obesity.
Dr. Evgeni Kolesnikov
Gold standard” and the American obesity pandemic
3
How Stem Cells are used in surgery
In the present days, Evgeni Kolesnikov not only lectures at Kyiv Medical University, but also operates actively. He practices Stem Cell Therapy in plastic surgery and treatment of autoimmune diseases at the Deva Clinique. Patients from Ukraine and abroad (the US, Europe, China, the Arab world states) use services of the medical center.
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Deva Clinique is one of the leading clinics in the field of Stem Cell development. At the initial stage, the clinic's specialists took the creation of these cells very seriously. Сonsiderable funds were invested, great scientists were attracted and really good cells were created.
"In 2017, we have already presented our data at the World Congress in Boston (author: the report of the Deva Clinique experts at the Stem Cell Summit 2017, USA) on stem cells. We provided information on the use of stem cells for patients with ulcerative colitis, Crohn's disease. We treated these patients with stem cells. Upon an injection, a stem cell tries to find the place where it is needed. For example, if it goes about ulcerative colitis, cells are needed in the intestines. This means that they work in the area where the tissue damage is detected. The stem cell can be reprogrammed into any tissue. Due to this, ulcerative processes heal well", - Dr. Kolesnikov.
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Our second report at the 2019 World Congress of Surgeons in Krakow was on the use of stem cells for wound healing after surgery (author: report of Deva Clinique specialists at the 48th World Congress of Surgery, Poland). And here again, referring to bariatric patients, for example: as a rule, when people lose weight rapidly, there are problems with immunity. They may be weakened and even get anemia. The use of stem cells makes it possible to heal wounds faster and better. We had no patients at all, who were operated with a use of stem cells with any complications of necrosis or tissue infection.
Stem cells help wounds heal after surgery. They are used during weakening of the immune system, for the treatment of pathologies in neurosurgery, diabetes mellitus, Parkinson's disease, multiple sclerosis, Alzheimer's disease.
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We also work with stem cells for the treatment of Alzheimer's disease, being today a big problem and mystery all over the world — no one knows who can get this disease, it does not spare anyone. It is like senile, since because of a partial memory loss, the complexity of treatment lies in the restoration of nerve cells and the work of the brain. This is the direction where we work (author: in Deva Clinique), so that we can treat patients with such diagnoses and problems. We work not only in Ukraine, but many people come to us from the UK, the US, Arab countries. We have a large foreign contingent, in addition to our citizens.
Either personal or donated stem cells can be used. Moreover, milk teeth contain stem cells. Deva Clinique has its own cryobank, where the umbilical cord, cord blood and placenta extract can be stored. These materials can be used, in case of emergence, at any moment.
4
Science develops rapidly
The discovery of all genes and intergenic intervals of human DNA molecules totality was an impetus for the launching of the scientists' work with stem cells. This is how researchers learned to understand the genetic makeup of our body.
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Science develops rapidly. To be honest, I did not expect that the human genome would be unraveled in my lifetime period. But it happened. This was brought into reality by two American companies: one state-owned, and the second — an international program, that included the United States of America, Japan, France, Germany, China and England. In 1990, they launched a 10-15 years program in order to unravel the human genome. A private company also began research, and in this parallel competition this genome was unraveled.
In 2000, a draft version of the study already existed, and in 2003 it was almost final. Although, according to Dr. Kolesnikov, 5-8% of the human genome still is not studied. An answer to an aenigma of the human genome enables studies of the genes that are responsible for a particular pathology. That means, if the one changes these genes, the disease can be prevented or defeated.
The 2012 appeared to become a breakthrough in this area, when two scientists — Professor John Gurdon from the University of Cambridge and Japanese professor from Kyoto University Shinya Yamanaka — became nobelists for discovering the possibility of reprogramming cells from mature to younger.
The 2012 appeared to become a breakthrough in this area, when two scientists — Professor John Gurdon from the University of Cambridge and Japanese professor from Kyoto University Shinya Yamanaka — became nobelists for discovering the possibility of reprogramming cells from mature to younger.
Dr. Evgeni Kolesnikov
Science develops rapidly
After that, an interest in stem cells rocketed. Evgeni Kolesnikov notes that there is even a theory that life expectancy depends precisely on the number of stem cell divisions.
5
A surgeon just brings a person to the normal life
From the very beginning of his career, Dr. Kolesnikov performed liver, pancreas, bile ducts operations and succeeded a lot in this. Then, in America, intensive work was a must: every day the professor performed 2 or 3 bariatric or cosmetic surgeries, everything was booked a month ahead. Thus, the surgeon operated on more than 4 thousand patients with pathological forms of obesity. Weight loss surgeries are popular, since a person feels a difference after that: sugar and blood pressure plunged, tachycardia stops, and T2D may disappear.
"And what happens then? Typically, a person needs 4 to 5 corrective aesthetic surgeries after weight loss, as the skin on a stomach and other body parts can sag. Young patients have elastic skin, it can recover in some areas. Middle-aged patients, whose skin is no longer so elastic, can have problems with sagging on a stomach, limbs — so-called "wings" on arms, thighs, and a face. Someone needs to remove excess skin; someone needs to tighten their breasts. I came to plastic surgery through bariatric surgery. So, I have been performing cosmetic surgery and contouring the face and body for over 20 years", — comments Dr. Kolesnikov.
Evgeni Kolesnikov states most people believe that surgeons want nothing but performing operations, and a doctor can always find a reason for an operation. I have different criteria. I never offer an operation to a person, pointing out any imperfections in his face or figure. And I never talk about them until they ask me. The patient must say what prevents him from living, what he does not like about himself. Only in this case the person is ready for the operation and will be grateful to you if you perform it well.
Dr. Evgeni Kolesnikov
A surgeon just brings a person to the normal life
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In fact, the professor is inspired by the results of overweight patients' surgery: as a rule, they are some of the most grateful patients. Patients who have lost a lot of weight — sometimes 60, 80, 100 kg — usually return to ordinary life, but with more inspiration. Very often they lose a lot of pathological syndromes: health improves, a feeling of lightness appears, and social life activates — someone became the village council head, published a book or got married. There are very positive results after that. The surgeon simply gets the person back to normal life.
For a patient to understand how he appears to onlookers, can be difficult; he cannot stop and wants to change literally everything in himself. However, there are reasonable limits, and one ought to take it into consideration. In case the surgeon does not look for these process reasons, and just fulfills the client's wishes, the bad consequences of such "transformations" will follow. Professor Kolesnikov underlines that, unfortunately, he has to re-perform operations after others:
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I have to perform a vast number of repeated operations. Unfortunately, in Ukraine, the medical education system is constructed in such a way that plastic surgeons often gain insufficient education and experience before entering an independent private practice. Assessing your own capabilities and the material to be worked with sometimes happen to be not easy. The reasons for dissatisfaction with the cosmetic operations results include unreasonable expectations the patient imagines. Sometimes patients ask to do what they think surgeons can do. Sometimes patients come to me with a photograph of Brigitte Bardot or other famous beauties and state: "I want a face like Brigitte Bardot has!" I try to explain that to make this dream come true, their own faces must be originally somewhere a little bit like Brigitte's face. The patient's expectations can be exaggerated. The fact that it will not work like this, but it can be done in another way should be explained.
As a matter of fact, Evgeni Kolesnikov sets up warm relations with patients. For example, Professor had a case when a patient took a photo with him after an extremely complex but successful operation and placed this huge portrait on the wall in his living room. For surgeons this seems to be one of the criteria to evaluate their own work.
One operated patient from the west of Ukraine congratulates the surgeon on all religious and non-religious holidays many years, and that is very pleasant since the patient's life has improved and he lives with more pleasure. Professor Kolesnikov says this is the greatest praise for him and jokes that thus he has already learned about all the church holidays.
One operated patient from the west of Ukraine congratulates the surgeon on all religious and non-religious holidays many years, and that is very pleasant since the patient's life has improved and he lives with more pleasure. Professor Kolesnikov says this is the greatest praise for him and jokes that thus he has already learned about all the church holidays.
The professor also tells a story being close to a fairy tale: a girl lived, was very successful, had two university diplomas. But then she suddenly grew stout, with complexes appearing. She tried countless methods and diets, but nothing worked out. Her father approached the in order to somehow get her back to society. The surgeon performed the operation, the girl lost weight, found her first love and did not forget about the professor:
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I left the office and saw someone running. She waved her hand and shouted: "Dr. Kolesnikov!" Such a waist, black dress, slim. A two-meter guy stood behind her. It was a husband, and they had a daughter. This is the moment to remember. People have returned to a normal life and this is the aim of our work.
This material is created with the support of the Deva Clinique Medical Center for Stem Cells Technologies, Plastic Surgery and Biorevitalization.
License of the Ministry of Health of Ukraine АЕ № 459234
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