From June 10 to 15, 2025, Dr. Holger Listle, a thoracic and abdominal surgeon from the Department of Cardiothoracic and Vascular Surgery at the University Hospital of Augsburg, Germany, paid a professional visit to the “Mikaelyan” University Hospital. This was the doctor’s third visit to Armenia and the university hospital. During the visit, he participated in consultations and surgical interventions, held meetings with local surgeons to provide methodological support and facilitate the exchange of experience. At the university hospital, he also delivered a lecture dedicated to minimally invasive surgery and answered physicians’ questions.
Dr. Holger Listle is the author of numerous scientific articles and holds a doctoral degree, having defended his thesis on the topic “Effect of inhaled lidocaine on pulmonary inflammatory process during experimental sepsis in rats.” The doctor is also actively involved in charitable initiatives and regularly travels to different countries. In 2016, he established the “Kat-ate” medical center in Uganda, which he continues to manage. We spoke with Dr. Listl about medicine and beyond.
— This is already your third visit to our country. What keeps bringing you back here? What changes have you noticed during this period?
— Yes, this is my third visit. First, I would like to express my gratitude to Professor Suren Stepanyan and Dr. Andranik Aleksanyan for the invitation. It is truly impressive to work with these individuals — we are united by our shared passion for surgery and our commitment to helping people. I’ve noticed major improvements at Mikaelyan Hospital — I’ve seen the technical modernization of the operating rooms, laparoscopic equipment sets — it was gratifying to witness such progress. I’m impressed by my colleagues; it was a pleasure to observe how they perform various complex surgeries. Professor Stepanyan is an ideal surgeon; his operations are exceptional. Both the hospital and the city of Yerevan are developing rapidly, and infrastructure is expanding.
— What is your impression of Armenia’s healthcare system and, specifically, its surgical field?
— I have been familiar with Armenia’s healthcare system for about 6–7 years. I must point out that currently, limited financial resources pose a serious challenge for Armenia, as well as for other countries, due to the absence of mandatory health insurance — unlike in European countries. Years ago, I noted that many problems could be resolved through compulsory health insurance. If people pay a small monthly contribution, they can insure their lives and health. The current challenge lies in providing high-quality medical care under limited financial conditions — this issue is also present in developed European countries, and governments, as well as responsible institutions, must address it. It is vital that policymakers and officials demonstrate respect toward physicians because no amount of money will save you in the face of a serious illness — only a doctor can help. Unfortunately, political decisions are often unfair from the doctor’s perspective. We suffer the consequences of poor decisions, which is why politicians should be closer to ordinary people, to doctors, in order to make informed decisions.
As for surgery — abdominal surgery is highly advanced in Armenia, especially at this hospital. I have no contributions to make here — they do not need my help. When you see how well your colleagues operate, it motivates you to continuously improve yourself and strive for excellence. It is very encouraging to see young surgeons so passionate about their work — patients feel this as well. There should be a focus on making thoracic surgical interventions more minimally invasive. I am confident this is achievable; it’s just a matter of time. The issue is also financial — minimally invasive procedures are not cheap, and since patients pay out-of-pocket, there is a question of affordability.
I’ve also noticed that smoking is very prevalent in Armenia, and this often leads to lung cancer. It would be beneficial to implement screening programs that would enable early detection of cancer and allow treatment with minimally invasive surgical methods.
— You’ve been collaborating with our surgeons for some time now. Are there plans to launch any joint projects? When can we expect to see you in Armenia again?
— Absolutely, we are discussing various projects. For example, I’ve invited Dr. Andranik Aleksanyan and his colleagues to Uganda to perform surgeries. I hope to return to Armenia in 3–4 months. I want to contribute to the development of thoracic surgery here.
— What do you like most about our country, and what has surprised you the most?
— My entire day revolves around surgery — the most interesting and pleasant part of being in Armenia is coming to the hospital and working with Professor Stepanyan’s surgical team. He has successfully built an exceptionally strong department — a collegial team with a warm atmosphere and great relationships with other specialists. In such a demanding profession, it is essential to have colleagues whom you can fully trust. Here, I have seen surgeons performing exceptional operations, with flexible and analytical thinking. When resources are limited, people use their minds to maximize what is available. As for Armenia — I enjoy the food, hospitality, and cultural and historical landmarks.
— Outside of medicine, how do you like to spend your time here?
— Armenia is a small country with a rich culture, and it’s very interesting. I don’t have much free time; my priority is surgery. I come to the hospital in the morning and then go to rest afterward. It is easy to organize leisure time in Armenia — there are many interesting places to explore.
— Since you’ve worked in many countries, what differences have you noticed between our patients and physicians and those of other countries?
— In Armenia, the doctor-patient relationship is quite intimate, and that is both a strength and a challenge. Patients come to us with their problems and entrust us with their lives. We carry a great responsibility, but we are not gods and cannot control everything. When you have a close relationship with your patient, it can complicate your work. In Uganda, patients and doctors are also close, but not to the same extent as in Armenia. There, people suffer due to the state of the healthcare system — the contrast between Armenia and Uganda is stark. Armenians, generally, are not overly demanding — they respect and appreciate doctors. German patients do not value doctors as highly — this is largely due to the system, which covers all their expenses and makes healthcare universally accessible and free. I believe that in Armenia, doctors are more appreciated — people may return to say “thank you,” and that is very pleasant. Germans do this only occasionally. In Uganda, a patient might return six months later and bring you a chicken as a sign of gratitude — this has happened to me personally. Sometimes patients fail to appreciate a doctor’s efforts and behave rudely — but one must not take it personally.
Here, physicians genuinely care for their patients, offering love and attention — they prioritize patient satisfaction and well-being. Our profession is difficult, and the responsibility is immense. Only good doctors can maintain a friendly relationship with patients — you must be very confident in yourself to do so. In Uganda, limited resources may explain why doctor-patient bonds are weaker.
In Germany, if you’re part of a good team, you may find doctors who are truly caring. Of course, in terms of technical equipment, Germany has far more resources. For surgeons, the condition of the intensive care unit is extremely important, as anesthesiologists and resuscitation specialists are your constant support. However, technical challenges can be resolved over time.
— Artificial intelligence is transforming many fields, including medicine. We are already seeing robots performing surgeries. In your opinion, is the development of AI a threat or an opportunity for physicians — particularly for surgeons? Is it possible that the demand for surgeons will decrease sharply in the future?
— It would certainly be nice to have a robot and keep it like a family pet. I believe that AI can be utilized in surgery — for instance, robots can be trained to perform simple interventions. However, this also depends on infrastructure, available resources, and financial factors. The question is — will the robot be better than a human in performing those surgeries? For example, in the case of a complex scenario like bleeding — how should the robot respond? We do not need devices that kill people — we need machines that save them. We want tools that are better than humans — and the question is whether that’s even possible.
