As surgeons we spend a lot of time outside of the operating theater determining who should be operated upon, when the surgery should occur, and what is the optimal surgical approach. Of course, all of these decisions are necessary in order to obtain an optimal outcome. All this being said, the major determinant of an optimal outcome depends on what happens in the operating theater. For cytoreductive surgery, a complete resection of peritoneal metastases is always the goal but not a goal that is easily achieved. All of the preoperative testing and decision-making is directed toward a totally successful result from the all-important surgical event.

The realization of the goals set preoperatively are dependent on a well-structured surgical plan of attack and sufficient surgical skill to complete that plan within an acceptable time frame and with the facilities available. How does one gain the surgical expertise to complete the optimal surgical event? It must start in the operating room working shoulder-to-shoulder with an expert cytoreductive surgeon. It continues by expanding one’s surgical expertise with every procedure. This expansion of talent in the operating theater can be realized through the study of videos narrated and performed by an expert CRS surgeon. This is where the Carcinopedia created by Pedro Barrios comes into use. Pedro has collected for us an audiovisual presentation of his immense surgical expertise. For his mastery of complex intraoperative problem-solving we can begin to comprehend the full extent of optimal CRS. 

These videos show a master surgeon at work where the optimal results are realized – within the operating theater. They are, however, by no means, the end of learning surgical technology. These videos are the starting place for cytoreductive surgeons to discuss, to share ideas and to go beyond what has been done before. They are not only a stimulus for all of us to expand our technical achievements but also a stimulus for all of us to grow as a community of surgeons with a commitment to control peritoneal metastases. Together we can identify the suboptimal outcomes, understand their causation and design a new pathway around surgical treatment failure. Our results are good. They can be made better. All of us are challenged toward continued improvement by Pedro Barrios and the compendium of videos known as the Carcinopedia.

I have known Dr. Barrios and his work for many years. For me, he is a key reference point when thinking about the treatment of malignant peritoneal diseases.

What has always impressed me is his extensive experience, interdisciplinary and interprofessional activity, holistic approach, his continuous scientific analysis of CRS+HIPEC outcomes in his patients, and his impeccable surgical technique. Within his team, every member has a precisely defined role, working in perfect coordination to reduce perioperative mortality and improve oncological prognosis.

In particular, his exceptionally low rate of anastomotic complications is remarkable and very difficult to achieve.

Experience cannot be taught—this is true—but it is crucial that surgical "craftsmen" like Dr. Barrios share their nuances and techniques to support others, especially young surgeons, helping them master and resolve intraoperative challenges.

The carcinopedia.org platform provides numerous tools essential for deepening knowledge related to CRS techniques.

The videos are of very high quality, capturing all the most relevant surgical details. For this reason, I strongly recommend consulting these educational materials.

I wish you all the enjoyment of discovering an elegant surgical technique and the fascination of surgery in a masterclass!

In the complex and demanding field of surgical treatment for peritoneal metastases, technical excellence, accumulated experience, and a firm commitment to continuous improvement are essential pillars in offering patients the best therapeutic opportunities. Dr. Pedro Barrios exemplifies these values to the highest degree. His extensive professional career, leadership in multidisciplinary teams, and rigorous approach to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) have established him as an international authority in this field.

I have had the privilege of knowing Dr. Barrios for many years, and I can affirm that he fully embodies the essential attributes of a true surgeon: deep pathophysiological knowledge, surgical skill, and, above all, an unwavering humanistic approach to medicine.

However, a surgeon is not defined solely by technical mastery. The vocation to teach, the generosity to share hard-earned knowledge, and the desire to contribute to the training of future professionals are also indispensable qualities. In this regard, Carcinopedia represents a contribution of immense value. This platform not only reflects the accumulated expertise of Dr. Barrios and his team but also transforms it into an accessible, structured, and high-quality educational resource, serving all those who wish to advance in the field of peritoneal oncology surgery.

Through carefully documented audiovisual material, the project offers the opportunity to observe complex procedures in detail, understand their surgical rationale, and analyze intraoperative decisions that only experience can shape. For young surgeons, it is an exceptional learning opportunity guided by excellence. For seasoned professionals, it is a source of reflection and continued refinement.

Carcinopedia is not a final destination, but rather a point of departure. It is an invitation to engage in dialogue, to innovate, and to collectively improve our approach to peritoneal disease. As a surgical community, we now have at our disposal a unique tool that inspires us to advance toward safer, more precise, and more human-centered surgical practice.