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Ladies and gentlemen, dear members and guests, Thank you for attending the 23rd Conference of the European Society of Thoracic Surgery in Lisbon. Here in the audience, I see many familiar faces from our previous meetings, Antalya and Elancourt Schools and other thoracic society meetings. I recognize leaders from our sister societies and expert surgeons whose work I greatly admire. I would like to welcome you all to the biggest ESTS event of 2015. Before we begin, I would like to express my deep sorrow for the loss of a Turkish chest surgeon 2 days ago. Kamil Furtun was shot in the hospital and died of his injuries. He was a brilliant chest surgeon, a lot of sick patients benefitted from his expertise. He will be sorely missed. I would also like to honour the memory of one of the visionary founders of our society of General Thoracic Surgery. Today’s congress would not be possible without our past leaders’ dream of developing the field of thoracic surgery and revolutionary changes to many of the procedures in our field. I regret to be the one to inform you that our beloved first president Dr Ingolf Vogt Moykopf recently passed away in March. He will always be remembered as a surgical innovator, clinical and research scientist, educator and mentor to the many surgeons who had the opportunity to know him. Surgeons from around the world have shared their condolences. Let us take a moment of silence to remember our first president, Ingolf. I would also like to thank our amazing councillors for all of their collaboration. Thank you to the great directors for all of their hard work. Thank you to the officers for your excellent leadership. I would especially like to recognize Sue Hesford for her exceptional direction and efforts. Of course, I could not be here today without the immense support of my loving family and my wife Ebru. Today, I would like to speak on creative destruction and the new era of thoracic surgery. Many of us here feel like we are in a wind of change with the adoption of innovative ideas, techniques and devices happening at breakneck speeds. It is uncertain if this fast pace has allowed us to adequately test and validate the ideas, properly implement them into educational programmes or follow safety precautions. This has deeply affected our field of surgery and the fate of our surgeons and patients over the past two decades. The variety of options increases decision-making dilemmas for surgeons and patients who question what procedures to accept. In this address, I will first illuminate the sources of the current uncertainty and confusion about fast technological innovation in the field of modern thoracic surgery. Secondly, I will describe the impact that this has on educational policy, transparency and social communication, and how the current generation of surgeons can position themselves as leaders in the field of thoracic surgery. Finally, I will discuss morality and professionalism in this rapidly changing era of medicine. Although there has been great progress in surgery, the adopted innovation has increased the cost of procedures. For example, patients favouring minimally invasive surgery may be a factor in some surgeons’ choices of what techniques to learn and when, and because of this young surgeons question what path to follow and what position to take in their education. They ask themselves how soon they should learn the latest technological innovative developments and whether they should become proficient of a particular technology like uni-port VATS or robotic surgery in the field of thoracic surgery or stay cross-disciplinary generalists with broad capabilities in the treatment of infectious diseases or classical open surgeries. Young surgeons wonder whether to pursue open surgery, minimally invasive surgery or both. They should learn mediastinal, lung cancer, chest wall, oesophageal, tracheal, emphysema surgeries in addition to transplantation, trauma, endobronchial treatment and surgery for infectious diseases. If they choose not to specialize in open surgery, I doubt they will be ready to respond to catastrophes that would require expert open surgical techniques such as bronchial or vascular sleeve resections or the treatment of a major vascular bleeding. Most mentors currently have a consensus to instruct classical open surgery techniques first, closed, minimally invasive techniques, second, and the latest technological developments before they are widely accepted. Presented at the 23rd European Conference on General Thoracic Surgery, Lisbon, Portugal, 31 May-3 June 2015.

ESTS Presidential Address - Creative destruction: a new era in the field of thoracic surgery