We may not have it all together, but together we have it all. The importance of intra- and interdisciplinary collaboration.

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This editorial highlights intra- and interdisciplinary collaboration among European gynecological societies, citing joint initiatives in endoscopic surgery training and female genital anomaly classification as successful models for improving women's health care.

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This editorial argues that the increasing complexity of modern medicine necessitates rigorous intra- and interdisciplinary collaboration to maintain a holistic patient-centered approach. It highlights how technological advancements in endoscopy and imaging have driven medical specialization, creating a risk of fragmented care that can only be mitigated through cooperative efforts between academic, industrial, and professional entities. The text illustrates this need for synergy by citing initiatives like the Walking Egg Project for global reproductive health and the GESEA program for standardized surgical training. Relevance to endometriosis: endometriosis is explicitly mentioned as one of the specific diseases driving the emergence of new subspecialties within gynecology.

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Abstract

The tremendous development of knowledge, the accumulation of clinical experience, and the enriching of everyday practice with the results of basic and clinical research created the need for splitting medicine in specialities and sub-specialities. Although this evolution is inevitable in order to meet the complex needs and demands of patients, we have to be aware of the risk of neglecting the holistic approach of a person in distress. Indeed, the organ-focused and pathology-centred approach of a patient may not exempt us of the rudiments of care such as the notion that a human being is more than the sum of its parts. This involves the absolute obligation for intra and inter-disciplinary cooperation. Recently, the European leading societies in Gynaecology, the European Board Obstetricians and Gynaecologists (EBCOG), the European Society of Human reproduction and Embryology (ESHRE), the European Society for Gynaecological Endoscopy (ESGE) and the European Academy for Gynaecological Surgery (+he Academy), have established some common impressive initiatives to improve women's health care. As a result of an intensive research programme coordinated by +he Academy with a multidisciplinary team of gynaecologists and surgeons a unique structured training and certification programme in endoscopic surgery is established. This project is a fine example making the dream of multidisciplinary approach reality and achieving some most impressive results. It is without any doubt a major step forwards in the improvement of the quality -assurance in endoscopic surgery in benefit of the patients care and has been accepted by our leading European and national societies. Recently, ESGE and ESHRE developed a new classification on female genital anomalies. An evidence-based -updated new classification published in the official journal of both societies was the ended result. THIS CREATIVE, SUCCESSFUL AND UNEVENTFUL COLLABORATION UNDERLINES THE NEED FOR RESPECTING SOME CRUCIAL POINTS: to clearly outline the topic of common action, to find the working platform, to define the method and to respect -independence of each society by clarifying the borders and the responsibilities. Keeping the window of the collaboration open is crucial for keeping the window to medicine of the future unlocked.
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A

Although sub-specialization allowed the development of research in depth and made the management of patients more adequate and safe, the ‘reconstruction’ of unity in human knowledge and clinical practice remains a difficult but necessary challenge. In the ideal World, profound collaboration between all those involved in medicine (physicians, scientists, engineers, industrial companies, universities and scientific societies) will overcome all possible hurdles in this process. When decided and applied, the results of joint efforts are really impressive. Recently, the ESGE, +he Academy and the ESHRE, realizing the need for united action, have established common initiatives thus changing a dream into reality. Female genital anomalies is a topic within the interests of ESHRE and ESGE since they are benign entities affecting reproductive potential of the women but, on the other hand, their treatment is nowadays feasible and effective with endoscopy. An evidence-based updated new classification has been recognized as an urgent priority for their management. EAGS, recognizing this need, has established, quite early, a scientific project on that issue; the characteristics of the new system have been clarified through a systematic and critical re-evaluation of the existing proposals and, thereafter, a proposal for a updated clinical classification of uterine anomalies to be used as the scientific background for a working group of experts in the field has been prepared (Grimbizis et al., 2013a; 2013b). It was obvious that ESHRE and ESGE, based on that preparative work, could further contribute to this common challenge from a different but supplementary point of view if a common “platform” of action could be found; this was accomplished with the establishment of a common working group under the code name CON(genital)UT(erine)A(nomalies). Once the platform was found, a scientific committee has been appointed to run the project, and DELPHI procedure was adopted as the method to look for a consensus between the scientists and to develop the new system. Once the project came to the end and the classification was ready, after getting approval by the Executive Committees, the new system was published in the official journals of the two Societies at the same time (Grimbizis and Campo, 2010; 2012) ( Fig. 6 ). This was really a very important step forward since the fruitful collaborations of the European Societies interested in the matter created actually a European classification system in a hot issue of clinical interest.

The

The examples mentioned above actually gave us an idea of the framework and the crucial points for a successful and uneventful collaboration between scientific Societies. First point is to outline the topic of common interest and clearly describe the aims of the collaboration. Secondly, it is important to find a platform for collaboration. This can be different depending on the issue and on the priorities, but it should certainly be functional and flexible. To establish the diploma programmes independent Steering Committees for each Society where established as for the new classification the work was performed by a common working group the CONUTA group. Third point is to define the method to accomplish the aims. This also could be different depending on the issue and the required final result. And last but not least, since it might be the most important point, is to clarify the borders of the cooperation for each Society. The own responsibilities and rights and the respect for each Society’s independence and its distinct scientific entity are key points of any common initiative. Finally, although rules are always the basis for an uneventful collaboration, the persons involved in each process are of equal importance. Open-minded, inventive, team-workers, opinion makers and bearing new ideas scientists are the ideal candidates for these initiatives. Collaboration (between societies) is not always an easy task to be achieved but it is certainly worthwhile because it creates the opportunities to explore new horizons in research and clinical practice. It is our assignment to collaborate in the pursuit of the best possible care for every patient worldwide and, now that the window to the medicine of the future is unlocked, it is our common responsibility to keep it open.

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