Biografía del Dr.Miguel Ángel Carbajo publicada en Obesity Surgery
https://doi.org/10.1007/s11695-018-3181-4

Dr. Miguel-A Carbajo is a pioneer in the fields of Laparoscopic and Obesity Surgery in Europe, Latin America, and the Middle East. He was born during the post civil war period in a historical village in the province of Palencia in north-central Spain called Dueñas and grew up in a farmer family.
Dr. Carbajo studied Medicine at the University of Valladolid (UV). Due to his early interest in history and literature, he wrote several historical books concerning the rates of illiteracy in deprived areas. Later, he was able to conduct literacy campaigns for adults throughout Spain.
He graduated with honors and joined the Unit of Surgical Pathology where he was initially responsible for the education of interns. In 1977, after obtaining a postgraduate degree in General and Gastrointestinal Surgery, he was placed in charge of the Surgical Unit at the University Clinic of Rio Hortega Hospital in Valladolid, where he was involved in all surgical subspecialties including thoracic, vascular, trauma, and gastrointestinal. It was there where he developed a great interest in teaching. During his years at the University Clinic, he taught at both the undergraduate and postgraduate levels.
As Chairman of the Infections and Nutrition Committee, and Planning Manager for the Emergency Unit, he developed a keen interest in the management of sepsis and severe intraabdominal infections. He was a member of the first programs to implement enteral and parenteral nutrition in these patients.
This led to the publication of innovative scientific papers on pancreatitis and peritonitis, as well as artificial nutrition and the use of glutamine as an intestinal restorer in patients with bowel resections and/or severe sepsis. Furthermore, as a means to overcome the scarce technology during that time in Spain, in 1979, he developed the first laparoscopic surgical techniques through optical lenses and a light source, performing hundreds of diagnostic and therapeutic
procedures. In 1989, he was appointed Head of the General and Gastrointestinal Surgery Unit at Medina del Campo Hospital (Valladolid), during a time when laparoscopic surgery with a camera was being introduced in France. After observing Dr. F. Dubois’s procedures in Paris, he immediately started the systematic implementation of cholecystectomy and other emerging laparoscopic techniques, which soon allowed his hospital to become a reference center in laparoscopic surgery both at the national and international levels. Over the following years, he organized more than 30 advanced laparoscopic surgery workshops, and several symposia on endoscopic suturing.

Numerous surgeons, not only from different regions of Spain, but also from other countries, participated. Dr. Carbajo developed the first laparoscopic method to repair medium, large, and massive incisional ventral hernias, without external sutures, later known as the “doublecrown technique.” Moreover, he was able to conduct and publish the first prospective randomized trial comparing open versus laparoscopic approaches to repair incisional hernias. These achievements led him to conduct weekly live surgical demonstrations for Spanish surgeons, as well as during numerous congresses and courses worldwide.
In 1990, he performed a successful vertical-banded gastroplasty in a high risk, super obese patient. This intervention reinforced his interest in Bariatric Surgery, a field in which he would work for the rest of his life. Dr. Carbajo published the first series of Lap-Bands in Spain and the world’s first case of an adjustable gastric banding penetrated into the stomach, which was successfully treated by a conversion to a Roux-en-Y gastric bypass (RYGB). Disappointed by purely restrictive procedures, he focused his efforts on the RYGB, performing them initially in a laparoscopic-assisted manner, and then in a fully laparoscopic fashion. At that time, he suggested that making the RYGB more malabsorptive was needed in order to improve outcomes.
In 1997, he co-founded SECO (Spanish Society of Obesity Surgery), and joined IFSO. He organized and presided over the 2004 SECO Congress in Valladolid, which had an unprecedented attendance and academic program.
He was also a Co-Founder of SECLAR (Spanish Society of Laparoscopic and Robotic Surgery), serving as their President in 2003, and MMESA (Mediterranean and Middle Eastern Endoscopic Surgery Association) where he was also the President during 2005–2006. This latter Association led him to host multiple seminars and courses which expanded training and knowledge in laparoscopic and bariatric surgery all around the Mediterranean basin. Dr. Carbajo rounded out his presidency by chairing an International Congress held in Malaga (Spain). Dr. Carbajo represented Spain for several years in FELAC (Latin American Federation of Surgery) and in ALACE (Latin American Association of Endoscopic Surgery), where he also served on its Executive Board. In fact, he is currently an active member of more than 20 national and international scientific associations, being the Founder and Board Member of several of them. Moreover, he was named an Honorary Member of various Portuguese and Latin American Associations, and a Member of the Review Committee of the EAC-BS (European Accreditation Council in Bariatric Surgery) for Centers of Excellence of IFSO. Conscious of regional needs, in 2000, Dr. Carbajo founded the Center of Excellence for the Study and
Treatment of Obesity and Diabetes. Two years later, he created the Association for the Promotion of Laparoscopic and Endoscopic Surgery, serving to this day as Director of both. Since their inception, these multidisciplinary institutions have served to bring a standardized service of excellence to thousands of patients, train hundreds of surgeons from different countries, and perform scientific investigations. These research efforts have resulted in a close partnership with the Endocrinology and Nutrition Research Center at the UV where he currently leads several projects related to obesity and its comorbidities, as well as their fate after surgical treatment.
In 2011, his Center of Excellence was approved by the EAC-BS (European Accreditation Council in Bariatric Surgery) of IFSO. Periodical auditing by this Council and their rigorous requisites for recertification have indeed validated the center’s methods and guided efforts to improve
outcomes.
After performing most of the operative techniques in bariatric surgery, both open and laparoscopic, in 2002, Dr. Carbajo assessed the concept of the Mini-Gastric Bypass (MGB). He embraced its potential benefits, but noted that several conceptual changes were needed in order to make it safer and more effective. As others, he was especially concerned about alkaline reflux and its potential consequences, thus, among other modifications, he developed an antireflux mechanism. The term BAGUA (Bypass Gastrico de una Anastomosis–in Spanish) or OAGB (One Anastomosis Gastric Bypass) was coined for him for this modified technique. He was also a pioneer in promoting use of robotic assisted technology for bariatric operations. Even though the OAGB initially faced strong skepticism, after performing the procedure in more than 3000 patients, and teaching it to hundreds of surgeons who have also reproduced the technique successfully, the OAGB has slowly become a sound alternative in bariatric and metabolic surgery. Multiple publications attest to this fact and several consensus conferences have also reached this conclusion.
Along with other surgeons, he founded the MGBOAGB International Scientific Club in Vienna during IFSO’s 2015 Congress. He is currently the President of the club, and is organizing and chairing its annual meeting in Valladolid in June of 2018. Dr. Carbajo’s academic determination led him to pursue further postgraduate titles. In 1992, he earned a PhD degree and was awarded the Cum Laude distinction in Medicine and Surgery by the UV. His thesis about the crisis of hunger, immunosuppression, and high mortality rates seen until the beginning of the twentieth century was recognized and published by the local government. In 1998, he graduated as “Doctor in Philosophy and Tradition Studies” from the UV. He wrote a doctoral thesis about hospitals and “barber” surgeon’s working methods from the sixteenth to nineteenth centuries.

Dr. Carbajo’s scientific links with the University continue through his extensive collaboration with the Experimental Surgery Research Chair, where he has co-directed several experimental theses regarding models of short bowel syndrome, small bowel transplants, hepatic and intestinal ischemia, absorption of micronutrients, fatty liver, and synthetic surgical sealants. He recently coordinated the first Doctoral Thesis concerning outcomes of morbidly obese patients submitted to OAGB, which was awarded a Cum Laude Distinction.
With regard to his editorial production, he serves as a member of the Editorial Board of several international scientific journals and a reviewer of numerous obesity and laparoscopic projects. Dr. Carbajo’s innovative spirit is deeply linked with scientific breakthroughs. Co-author of 15 chapters in laparoscopic and bariatric surgery books, he also authored more than 170 scientific articles and participated in close to 600 conferences, including oral presentations, videos, and other scientific and practical hands-on activities. He has also published more than 200 informative articles and appeared in the media in order to raise awareness about the serious risks and complications of sedentary lifestyle, bad eating habits, overweight, and obesity.
Besides his academic and scientific interests, Dr. Carbajo has a great passion for writing, art, poetry, history, and more recently, photographic safaris. In 2009, he was ordained Knight of the “Order of Saint James” (Santiago de Compostela), which dates back to medieval times. He currently lives in Valladolid with his lovely wife Inmaculada who also works at the Center of Excellence. She is a bariatric psychologist but also dynamically coordinates many of the center’s activities. Their older son is a lawyer who lives in Russia and has given them two beautiful grandchildren. Their younger daughter recently finished high school and studies filmmaking in London’s University. They all love to travel and try to reunite the family whenever possible.

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