Shija celebrates 26 years of laparoscopic surgery in Manipur

Dr Kh Palin
Shija Hospitals & Research Institute (SHRI) completed an illustrious 26 years of laparoscopic surgery today. SHRI performed the first laparoscopic operation on May 10, 1996, using instruments permanently installed at the then-hospital on RIMS road, Lamphel, Imphal.
Dr Purnendu Roy, from Kolkata, was the tutor and guide and under him, the surgeons of SHRI learned laparoscopic surgery and took over the laparoscopic surgery procedures from him. Despite significant skepticism among doctors and patients, Shija was able to do remarkable laparoscopic surgery on the gallbladder and appendix on numerous occasions and establish it in Manipur. As a result, patients, their families, and other surgeons and experts recognized that laparoscopic surgery was here to stay and to proliferate.
Shija Hospitals then installed the first video endoscopic machines (Endoscopes) in 1997, allowing the hospital’s specialists to perform upper and lower GI endoscopy as well as therapeutic procedures. Similarly for colonoscopic procedures, not only diagnostic but also therapeutic colonoscopy were done at the hospital. It included performing polypectomies, taking biopsies, to stop bleeding, and inserting stents in colon cancer to provide palliative treatment for inoperable cancers of the colon.
In 1998, the hospital established ERCP (Endoscopic retrograde cholangiopancreatography) for the first time in Manipur and was then able to proceed to treat patients with CBD stones, and pancreatic tumors which blocked the CBD causing jaundice. It also enables the surgeons to put stents to relieve deep jaundice in the patient so that these patients who needed to go to places like Guwahati and Kolkata for such procedures were now able to access the facilities at SHRI. From then on, the laparoscopic surgery progressed rapidly and the confidence of the people and other surgeons rose and resulting in a high volume of laparoscopic surgeries.
With the establishment of the first Harmonic Scalpel in South-East Asia (an instrument used for laparoscopic surgery that does not cause bleeding and is safe for the patient) in January 1997, advanced laparoscopic surgery could begin in Manipur very soon.  As a result, the hospital was able to do a lot of advanced laparoscopic procedures which involved the esophagus, stomach, rectum, tumors of the liver, cysts of the liver, and pancreas. The experts at SHRI began performing bloodless surgeries for breast, hemorrhoids, and thyroid using a harmonic scalpel. With rapid progression into advanced laparoscopic surgery, Shija Hospitals became a center known for laparoscopic in the region as well in the country. Surgeons at SHRI quickly became faculty members teaching other junior surgeons skills and arts of laparoscopic surgery joining the Association of Minimal Access Surgeons of India (AMASI).
Recognizing the potential, skills, and abilities of the surgeons at SHRI, the association made Dr Jugindra Sorokhaibam, a faculty member, and executive committee member and gradually progressed to become the president of AMASI (subsection of ASI-Association of Surgeons of India), the largest association of Minimal Access surgeons in the world with over 11,000 members. Today, he is one of the faculties who go to different cities and towns of the country as well as different countries like Bangladesh, Sri Lanka, Myanmar, and other Nations to operate and demonstrate surgeries to the surgeons of these countries. Later two other senior surgeons at Shija, Dr Devendra Kh and Dr Chongtham Chandragupta also became National faculties of AMASI. Dr Jugindra has also been instrumental to bring skills courses to Imphal to develop the skills of younger surgeons in the region as well as those of the countries. He also formulated a safe laparoscopic cholecystectomy (Gall Bladder removal) training program which was being demonstrated in various parts of the country to bring laparoscopic surgery to a very safe level and standard as expected by the association.
SHRI is currently performing all types of advanced laparoscopic surgery, innovating and performing newer techniques such as laparoscopic CBD exploration and laparoscopic cholecystectomy in the same sitting or ERCP and laparoscopic cholecystectomy in the same sitting, so that patients only need to stay in the hospital for 1 or 2 days before being discharged, even for conditions requiring multiple procedures that can be combined. Laparoscopic hernia surgery, as well as pancreatic, stomach, liver, and kidney operations, including donor nephrectomy for kidney transplantation, are being performed on a regular basis at SHRI. Even during the Covid-19 pandemic, the laparoscopic surgery did not stop. Patients with Covid-19 got laparoscopic surgery procedures as needed.
So with the developing procedures and skills at SHRI, patients from different States as well as from the neighboring country of Myanmar came looking for laparoscopic surgery so that they are relieved of their illness as quickly as possible through the keyhole surgeries and quickly able to return home or go for sight-seeing in India. For example, Buddhists coming from Myanmar would like to go to Gaya, Bihar after the surgery if they quickly recover. So these are things that are attracting health tourism to the State and adding to the economic development of the State. Laparoscopic surgery at SHRI has helped to put the hospital on the map of healthcare not only in the North East but throughout the country. Acknowledging the abilities of SHRI, two of Myanmar surgeons and 6 nurses were also trained at Shija in surgery and critical care services. Shija Hospital is taking up the responsibility of training surgeons in laparoscopic surgery who would like to develop their skills.
Because of the rapid advancement and talents, as well as the number of procedures performed, laparoscopic surgery training for PG students became practicable, and DNB (post-graduate) surgical students have been trained in laparoscopic surgery. With rapid development in endoscopic and laparoscopic procedures that includes endo-urology procedures like PCNL, URS, RIRS, TURP, etc. SHRI became the destination for those patients who wanted to undergo minimal access surgery. A result of the need to increase the number of beds for the hospital proved to be a great boon in establishing the first homegrown private medical college in North East India with 150 MBBS students.
With these developments, Shija is looking forward to very advance, safe, and beneficial minimal access surgery services in the region which can serve not only the people of the State and neighboring States as well as those patients from Bangladesh and Myanmar. Shija hospital in collaboration with AMASI has also conducted many free laparoscopic surgery camps in remote corners of the State and also in Monywa general hospital as well as the general hospital at Mandalay, Myanmar where senior faculties of AMASI went by road to Mandalay and operated there to train surgeons of Myanmar.
Along with the laparoscopic general surgery, laparoscopic surgery in Shija Hospital was developed for gynecology and thoracoscopic surgeries, where operations for removal of operable cases of cancer of the esophagus are being done and thoracoscopic procedures for diseases of the pleura are being done, all form of gynecological operations which includes ovarian surgeries, hysterectomies, endometriosis, myomectomies is regularly being done by all the gynecologists practicing at Shija Hospitals. Similarly, the urologists at Shija hospitals are now very adept in doing laparoscopic procedures for kidney, ureter, and urinary bladder. Removal of the diseased kidneys is most often done by keyhole surgery by urologists. Surgeries of other organs in the abdomen like colon surgery, surgery of the rectum, tumors within the abdomen, and also acute abdominal condition such as following trauma and peritonitis with the ulcer perforation, etc. are being done by keyhole surgery at SHRI.
Laparoscopic surgery is being used extensively in all surgical settings at the moment. Shija is very excited about moving forward and establishing a Robotic Center with Robotic Procedures in order to increase the accuracy and finesse of surgery using robots, which are growing globally and slowly progressing in India.
Dr. Kh. Palin, MS, MCh (Plastic Surgery), FICS, is Consultant Plastic Surgeon and Chairman cum Managing Director, Shija Hospitals