noviembre 28, 2021

THE OPINION OF…

VLADIMÍR BENEŠ

"WE HAVE ORGANIZED WITH THE WFNS FOUNDATION MANY COURSES THROUGHOUT THE WORLD, MOSTLY IN AFRICA"

Prof. Vladimir Benes (Prague) is an internationally recognized leader of Neurosurgery. One of his most acclaimed contributions in education comes from his active co-chairmanship of the WFNS Neuroanatomy Committee.

Prof. Vladimír Beneš

What is your preferred hobby: neurosurgery or collecting beetles?

Both. Eleven months a year, it is precise neurosurgery and one-month unpredictable adventure. I love both and the balance is, from my point of view, exactly right.

Have you ever had to face any risks when picking up a beetle?

Certainly, being attacked by an elephant in Zambia; getting lost at night in thorny shrubs of Western Mexico; jailed for 2 days in Sin-Tian province of China as we entered a prohibited area; acquiring severe salmonellosis in Gansu, and barely avoiding a landslide in Bolivia. And I was directly bitten by a scorpion with 3 months of left-hand hypesthesia.

Vladimír Beneš and his passion for beetles

Your father is a neurosurgeon, your son is a neurosurgeon, and you are a neurosurgeon? Did the three of you discuss neurosurgery?

My father, unfortunately, passed away this July at the age of over 100. Until the very end, he remained inquisitive about neurosurgery — and for sure– all 3 of us discussed neurosurgery (and sports, for that matter) whenever we met. 

Christmas family gatherings were not much unlike neurosurgical congresses. The wives always tried to divert us to some other topic but invariably failed.

Vladimír Beneš, three generations of surgeons

What is the best professional advice your father gave you? And you gave your son?

The same. Be honest. 

When did you first see a human brain?

When I was 6, I got one large A grade on the last day of my first year at school. I went to show the certificate to my father. At the time, he was in the OR and the nurses sent me there since, in the late 1950s, microbes were most likely not yet discovered. 

My father stood above the sitting patient who had his skull opened and under local anesthesia. I proudly showed the grade to my father; he said nothing, expecting nothing else. But the patient turned his eyes to my father and said, “you have a smart son, professor.”

Prof. Vladimír Beneš during surgery

What is most attractive about neurosurgery?

Its complexity, diversity, intellectual appeal, its awe and mystery, many unanswered questions, and many mental and technical challenges. Well, everything.

Is it always better to operate?

Not at all. I often emphasize that the best surgery is no surgery at all. I would not operate on an asymptomatic patient with small meningioma or schwannoma. 

First, I would confirm the growth by repeated MR or wait for the first appearance of symptoms. It’s always an individual decision. Actually, it is more difficult to decide against surgery. Should something happen during the wait and see period, you may be blamed much more than if something goes wrong during surgery. 

Is observation also a procedure?

By all means– continued observation is a legitimate modality option for treatment.

What was the most difficult operation you had to perform?

In 1990, I operated on 8 children with a vein of Galen aneurysmal malformation (rare intracranial vascular anomalies typically found in children). The established diagnosis of one of the 8 cases was choroidal and this I consider my most challenging surgery. All 8 patients survived and are now healthy adults with families of their own.

Supra-cerebellar infra-tentorial approach for petroclival meningioma using exoscope

Do you still remember the first operation you performed?

Yes, it was a skull fracture.

What is your relationship with the WFNS Foundation?

I served one term as the chairman of the WFNS Neurosurgical Anatomy Committee. And as such, we have organized many courses throughout the world. On numerous occasions, we were working together with the Foundation, mostly in Africa.

What are you working on now at the WFNS Foundation?

For now, I am still working on the Committee. The relations with the Foundation are the same as in the past. I am sure my successor, Professor Imad Kanaan, will deepen these relations and I am always ready to participate and help.

Museum MuMo, Prague – Exhibition Professor Beneš Cabinet of Mysteries

Do you think the WFNS Foundation will expand?

Certainly, as I consider the foundation to be an especially important part of WFNS, as it addresses the needs of neurosurgery in disadvantaged countries.

Do you consider yourself a leading neurosurgeon in your country?

Well, being modest… I do.

Where is neurosurgery heading and is it changing a lot?

We have many aspects. Scientifically, more precise evidence along with more individualized treatment. Some contradiction, but when evidence is considered like traffic signs, we should easily manage. Next is the permanent lowering of treatment risks and preserving a high quality of life. It is fine if the gardener works as a gardener after surgery, but there is something wrong if a scientist is working as a gardener after the same surgery. We also need to focus on meeting the patient’s expectations. And I hope to see some results from promising areas of robotics, neural prostheses, neurotransplantation, and modulation.

Your goal now is…

Easy, to enjoy myself.

Vladimír’s department team

Illustration of Prof. Vladimír Beneš 

«I consider the foundation to be an especially important part of WFNS, as it addresses the needs of neurosurgery in disadvantaged countries«