Hands that Heal, Hearts that Care - Few Tips to Surgeons

I am very happy to write for our state journal, Karnataka Journal of Surgery (KJS).

It is with great pleasure that I congratulate Dr Venkatesh, the chief editor of KJS, who will be taking over as President of Paediatrics Surgery Association of Karnataka in the month of August 2025. On behalf of Karnataka State Chapter (KSC) - Association of Surgeons of India (ASI), as a chairman of KSC-ASI, I wish him the best success in his new role as a leader of the association. I am very confident that he will improve the association to his best ability and take it to greater heights. I also take this opportunity to request each and every one to help in grooming this new baby of the association, Karnataka Journal of Surgery, by contributing quality articles and by helping the editorial board. I would like to also congratulate our national EC member Dr Diwakar Gaddi, who has been appointed as secretary of the Association of Surgeons of India. KSC-ASI is proud to inform all of you that he is the first surgeon from Karnataka to be appointed to the secretary post. Our best wishes to you, Prof Diwakar Gaddi.

As a chairman of the KSC, with the help of my dynamic EC (Executive Committee members) we have initiated many new projects, such as improving rural health care systems in the backward areas of Karnataka by arranging free rural health service awareness camps, guiding needy patients to appropriate hospitals, helping them get treatment and educating the poor masses. Social service is an important aim of the ASI. We should be thankful to the Almighty God that we have been given the ability to treat a human being. Keeping that in mind, I strongly believe our contribution to the society in the form of charity, help for the needy, guidance to patients, saving a life with blood donation camps, etc., and will definitely bring a respectable image in the society. These gestures and initiatives, in the long run, will build a rapport between the public and the medical community, translating to decreased friction between the patients and surgeons.

As you are aware, every surgery can have complications, especially the complicated surgeries.^[1] In India majority of the patients, particularly in the rural setup present themselves late to the hospital, e.g., for abdominal emergency surgeries, more than 48 hours with an advanced stage of peritonitis or sepsis and shock. It is our responsibility to ensure good communication, explain the need for surgery, how emergent the surgery is, whether it requires further referral and intensive care, and the cost involved. We must always bear in mind their economic and cultural background while treating these patients. Communication is a vital part of the doctor-patient relationship.

The next initiative we have undertaken is about medicolegal awareness amongst surgeons by arranging workshops. This, we perceive, is the need of the hour. I humbly request all our surgery colleagues and the entire medical fraternity to follow the standard guidelines included in the WHO surgical safety checklist.^[2] I also encourage you all to develop your own hospital guidelines (without compromising patient safety) and have it readily available because many of our patients may not be able to afford to standard guidelines laid down by rich countries. This will help you in case of litigation. Safe surgery should be our thumb rule. If you cannot handle the situation during surgery (at operation theatre) or the postoperative period, have a low threshold to call for help or call another colleague. Stay united always.

In this age of high speed and high mobility, surgeons are increasingly faced with the treatment of trauma cases, whether in medical colleges or in rural setups. All of us are aware that one major cause of death, disability and damage is high-speed and careless driving. Many studies have proved this too. It is distressing to hear that over 1.7 lakh persons were killed in road accidents in 2023.^[3] The majority of these are in the young, productive age group, and the impact is tremendous on their families as well as the society.

KSC-ASI has initiated awareness of vehicle accidents – our slogan will be GO SLOW. I am requesting our surgery colleagues to arrange at least one trauma-related activity in your city branch of KSC-ASI this year and continue every year too. We cannot shy away from responding to trauma victims, and there is no justification in not knowing basic skills of resuscitation. KSC-ASI has introduced a trauma session in the MIDCON, Mangalore, with separate prizes in the trauma section, preferable to road traffic accidents. The health awareness trauma day event is on October 17^th. I would like to request each and every surgeon to do some activity related to trauma.

We would like to continue the free surgery camps as done in the previous years. Free rural surgery camps, which have been the flagship programme of the KSC. I request the city branch surgeons to come forward voluntarily for such a noble event, considering that we still have many patients who are below the poverty line. I request you to donate – generously and voluntarily – necessary materials, e.g., mesh, suture materials and financial assistance. Your expertise in conducting the surgery itself would, undoubtedly, be a generous act of your commitment to the society.

We would like to improve the strength of our association by enrolling new surgeons in KSC-ASI, bringing them into the mainstream of KSC, thus enhancing our friendship and bonding and developing leaders. Let us be also aware about quacks: how they get false certificates, how they conduct illegal surgeries and how they fool poor innocent patients. If you are aware of any such individual, please bring this to the notice of the regulatory bodies such as the Karnataka Medical Council or even to our association secretary. As responsible citizens of the country, it is our duty to point out the wrongdoings and suggest how it can be corrected.

It is very worrying how medical colleges are mushrooming but lack infrastructure, adequate faculty and patients. The net result of this is inadequate training and skills. Surgical training cannot be learnt by only theory but needs to examine and operate on a good number of patients. To a certain extent, surgical skills can be learnt by using simulators and wet labs. But surgery is a mastery, which can come with persistent hard work, continuous learning, and a passionate mind. I consider lack of skills – Hyposkilia^[4] is the chief cause for patient’s morbidity, mortality, and litigations. So, young surgeons should look into this aspect very seriously to get proper training, then join a hospital wherein you are trained further under some skilled surgeon and protected. You will hopefully get a Guru and then further professional jobs. Please be focused and learn as many skills as possible.

General surgery is not residual surgery, and a general surgeon is not a residual surgeon. All that is required for surgeons is to develop an attitude to learn throughout life. A good general surgeon can do excellent laparoscopic surgeries which even a gastro-intestinal (GI) surgeon may not be able to perform. A general surgeon can treat venous diseases well and can perform a thyroidectomy and parotidectomy also well. He can be an excellent trauma surgeon. With added training in endoscopies, both diagnostic and therapeutic, he can be a very successful surgeon, too. It still has lots of scope, provided you are ready to develop skills. As a medical college teacher, I also wonder at times whether I am doing justice to my role as a teacher, surgeon, and researcher. I must say that we do a lot, but there is always much more we can do. One area that we can improve is research. My earnest request to you all is to plant the young minds with seeds of research, ignite them, and get them hooked on to it. Most often, it is the gentle nudge that is required for these capable young people to go on this path and achieve great success.

Before I conclude, I would like to remind you all to get ready for the ‘Surgeon’s Day’ celebrations, for which our national executive committee (EC) member, Dr H.V. Shivaram is the chief coordinator. Let us all look forward to doing more activities and more service, and together, let us all be true to our title – Surgeon. The acronym for a surgeon for the year 2025–2026.

Our Vision – The SURGEON Acronym

• S – Skilled and Safe

• U – United and Untired

• R – Responsible and Responsive

• G – Generous and Gracious

• E – Energetic and Empathetic

• O – Observant and Open-minded

• N – Noble and Novel

(Compiled by Dr Venkatesh and Dr Savitha K)

My best wishes to all of my dear surgeons.

Dr K. Rajgopal Shenoy

Chairman KSC-ASI

1^st May 2025