Dr. B. B. Agarwal is consultant at Sir Ganga Ram City Hospital, Sir Ganga Ram Hospital and Dr. Agarwals Surgery and Yoga, Delhi. He is first Laparoscopic Surgeon in the world to have successfully developed the technique for Laparoscopic Cholecystectomy without using any electricity or energy. Curofy talks to to him to know more.
- You are one of the most renowned surgeons in the country. Please tell us about your journey?
Thank you for being kind, but i just walk miles broken into inches with millimeters of lateral zay walking. I was born in an atmosphere of tradition wed to modern education. Brought up in traditional Dilli 6 business background with an adoring medico uncle, surrounded by friends of various faiths visiting different systems of healers & visiting legendary doctors like Dr. KC Mahajan whenever accompanying a sick family member. Fortunate to complete my entire education till becoming a doctor, within walking distance of my home. Walking from home to MAMC made Red Fort our favored play ground. This background made me a rebel in thought about modern medicine & respectfully inclusive of traditional systems. During my third year of MBBS, i went to train in Yoga under the mentor ship of Swami Dhirendra Brahmchari, with whom i spent one year, graduating as his favorite disciple & with a gold medal. Having seen Dr. KC Mahajan as a powerful presence in Dilli 6 circles, chose to be a surgeon & trained at MAMC, LHMC, PGIMER, RMLH & AIIMS. The rebel in me made me return from UK despite having an ODTS scholarship, telling my seniors there , that there was nothing new & exciting in the work that they were doing. Always thought of becoming a faculty in some Delhi Medical College ( going out of Delhi was never an option for me),but couldn’t succeed. Dr. KC Mahajan knew about it & blessed me with my current position. Sir Ganga Ram Hospital provided me with the best academic atmosphere with freedom to pursue my surgical rebellion. That is how i worked on integration of yoga & conventional wisdom in my practice of surgery. My belief in dissection being distinct from hemostasis led me to pursue my work on avoiding energised dissection in laparoscopic cholecystectomy. I think that work led to my recognition as a notice worthy surgeon by people like you & others. It has been a very stisfying work with many cited publications including an editorial in the apex journal of laparoscopic surgery i.e. Surgical Endoscopy. Along this journey i was blessed by seniors like my guide Prof. Narinder Singh, Prof. SN Wadhwa, Prof. KC Mahajan & many others. I met many fellow pasengers, many of whom became my teachers incognito & gave me everlasting friendships. The most satisfying part of this journey remains the love of my patients & the opportunity i keep enjoying being with the young talent stimulating them to think out of box & laterally beyond the science of medicine. My multicultural heterogeneous background has made me put my patient before self. Patient safety has become an article of faith for me, hence my ongoing journey to make laparoscopic surgery safer & safer by avoiding the use of surgical energy as far as possible.
2. You have been featured extensively in the media regarding stapler haemorrhoidoepxy for piles. Tell us about your experience with this procedure and what is the learning curve for a general surgeon wanting to learn this technique?
My personal friendship with the inventors & pioneers like Dr. Antonio Longo & Dr. Roland Scherer has been instrumental in giving me the current status amongst the stapler driven colorectal procedures. It’s a good procedure for symptomatic hemorrhoidal disease. It has all the qualities of minimally invasive surgery i.e. its a daycare ambulatory procedure, it is almost painless & it allows the patient to resume ABCDEF with in 48 hrs. ( A-Activity, B-Bath, C-Commitments, D-Diet with spices, E-Exercises, F-Fun & Family life). Pain after hemorrhoidal surgery is a big deterrent, this being absent in stapled procedure, has truly driven the popularity of this procedure. Scientifically also it is the first procedure that addresses the cause of piles i.e. internal prolapse of rectal mucosa. My experience with it has been hugely satisfying to myself as well as my patients. The patient reported outcomes have been improved further due to integration of Yoga & traditional spices along with the surgical procedures. We have published the benefits of Yoga & Indian spices for the patients undergoing stapled hemorrhoidopexy. Like for any surgical procedure the learning curve will depend upon the entry level of the trainee. If the trainee has an adequate exposure to anorectal surgery & has used staplers in surgery, than observing 25 procedures & getting proctorship for 2 procedures should be sufficient.
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