Diego González, traveling surgeon: ‘I operate all over the world’

Diego González Rivas has just arrived in his hometown, A Coruña, after stopping in Madrid and Lisbon, where he landed last week on his return from Kuwait. Suitcases and planes are part of his daily routine. During December he has also been to Azerbaijan, the Czech Republic, Germany, and Bucharest. He will spend Christmas in India and New Year in Indonesia, from where he will travel to Vietnam. He is a traveling thoracic surgeon, who at 50 years old has operated on more than 10,000 people in 136 countries after revolutionizing operating theatres.

What used to involve opening up the patient and separating the ribs is now reduced to an incision of a few centimeters with thoracoscopic or robotic surgery. Sometimes, these interventions are carried out without tracheal intubation or general anesthesia. Thanks to these two techniques, which González developed in 2010 and 2021 respectively, patients can be discharged from hospital within 48 hours after being operated on for lung cancer. He heads the thoracic video surgery program at the Shanghai Pulmonary Hospital, the largest clinic in the world, and in 2025 he will present a book, Healing the World: Diary of a Nomadic Surgeon.

Question: Did you always know that you wanted to be a doctor?

Answer. Yes, I always wanted to help others. My mother was a nurse and I loved going with her to the hospital because I saw that people were going in sick and coming out okay, usually. When I was little, my family recorded a Christmas video message in which I wished people a happy holiday and that no loved ones would die. This was what I cared about.

Q. Why did you specialize in thoracic surgery?

A. I wanted to be a surgeon and I had three options: plastic, cardiac, or thoracic. The latter was not very well-known, but just when I graduated a lung transplant program started in A Coruña of which I could be the first resident. I had an intuition and I went with it, I knew I would be fascinated.

Q. Has postoperative care evolved much since then?

A. Of course, one of the things I hated most about my profession was seeing patients in bad shape after surgery. Thoracic surgery is the most painful of all because the intercostal nerves are in the thorax, a rigid organ that requires separating the ribs to be able to access it openly, which causes pain that can last a lifetime. I saw dramatic cases in the postoperative period with many complications and the risk of infections, pneumonia, and thromboembolisms.

Q. Did you know that medicine offered other alternatives?

A. I believed that the way things were being done had to change. I discovered video surgery, which was only performed in Spain in Seville, on a small scale, but was more common in the United States. I went there in 2006 and learned the technique in hospitals in Los Angeles, New York, and North Carolina, where I found out that surgeon Thomas D’Amico was the only person capable of operating with only two incisions, and I trained with him.

Q. Did you improve this technique?

A. Yes, in June 2010 I performed major lung cancer surgery for the first time in the world with a single four-centimeter incision. Now I can do it in a smaller size. It was a revolution and a new era began with a technique called Uniportal VATS (minimally invasive video surgery with a single cut in the chest). It allows direct vision with very ergonomic instrumentation. The patient is at home within 48 hours.

Q. Did your professional career take off at that time?

A. I started to generate international interest, although there was also criticism because I was creating something new that broke with the established order. My own boss at the hospital in A Coruña did not accept it. I lived through some tense years, but my team always believed in this project and we continued forward. Life is full of obstacles and these make you grow.

Q. Did you want to show your discovery to the world?

A. I wanted all surgeons to learn this technique because it is very appreciated by the patient, and I started my crusade around the world to teach it. Medical students already study it in faculties. It is not only used to operate on lung cancer, it’s useful for all chest pathologies. In 2021, I also developed robotic surgery (Uniportal RATS) and, in addition, I cure hyperhidrosis in the palms of the hands with a 15-minute operation, like the one I performed on the [Spanish television] presenter David Broncano. That’s why this operation went viral.

Q. In which country did you first become interested in spreading your single-cut technique in the chest?

A. In 2012, I was invited to give the first conference in Singapore, where a hospital was performing 30 lung surgeries a day and specialists from all over Asia came. I started performing live surgeries in Hong Kong and offered classes in more than 60 Chinese cities. I was amazed by the Asian technology and founded the thoracic video surgery program at the Shanghai Pulmonary Hospital, the largest in the world, to attract professionals from all over. They train for two weeks and return to their countries of origin to develop the technique; it is the fastest way to expand worldwide. I was named an honorary citizen in northern China.

Q. What fulfills you the most?

A. Operating in developing countries is what makes me happiest, it gives me a lot of peace and satisfaction because it is where I have the most impact. Saving a life there is wonderful. At first it was an odyssey to perform this type of surgery in some territories, where we lost power in the middle of operations. They have very limited resources and we need high-definition equipment and specialized anesthesiologists. In recent years I have visited more than 30 African countries. That is why the Diego González Rivas Foundation was born in 2022, which raises funds to work in these countries with peace of mind.

Q. Has the foundation allowed you to fulfill dreams that seemed impossible?

A. I have operated in Tanzania, Kazakhstan, Sierra Leone, Peru, and many other territories. This year I achieved my main goal: a mobile hospital equipped with all the technology to move easily to different parts of Africa. We inaugurated it in Ghana. For the first time in the world, minimally invasive surgery was performed in a mobile unit with high-definition cameras, solar panels, satellite connection, bronchoscopes, sterilization systems, surgical scrubbing, and a resuscitation area. We saved people and offered them the same health conditions as in Europe and the United States.

Q. Are you a traveling surgeon?

A. Yes, I am a nomad. I work in dozens of hospitals, I operate all over the world, even on weekends. I travel alone, but in each country I have a different team. I never lose contact with the patients I care for, even if I have to leave the next day for another city.

Q. What adverse situations have you faced?

A. There have been many, but I remember a girl in the Democratic Republic of the Congo who had swallowed a key and it had been stuck in her lung for two years. She was dying and we operated on her. Three days later, we discharged her and she was happy. In China I assisted a prisoner who had tried to take his life by stabbing himself in the chest with an awl, and in Tanzania I operated on a girl whose lung had been completely punctured by a rib years earlier, probably after being abused.

Q. Do you operate where others don’t dare?

A. I have more experience in complex cases because I deal with them every day. I perform 1,000 lung cancer surgeries a year, whereas my colleagues in Spain normally do 100. I receive numerous cases every day of patients with tumors that have been rejected [for surgery] because they are technically complex, so I deal with them, but many I cannot cope with either. I always have to stick to oncological principles.

Sign up for our weekly newsletter to get more English-language news coverage from EL PAÍS USA Edition