General Information
Department of C.T. Surgery
General Information
• The journey of CTVS Department in S.M.S Medical College Government of Rajasthan begins with formal inauguration in the year 1978 and Dr. G.C. Sharma became the first Head of the department.
• In the beginning, it was mainly Thoracic Surgery department with limited Closed heart surgery and vascular surgeries.
• In the year 1986 department went one step forward, with inclusion of open heart surgeries in various camps organised by Dr. D.S. Saksena from Bombay Hospital, Mumbai and since then valve replacement and congenital cardiac defect surgery was started.
• In the year 1993,Coronary Bypass Surgery was added in the headship of Dr. Karan Singh Yadav with proctorship of legendary surgeon Dr. Naresh Trehan and Team.
• M.Ch. Post Graduate Training Programme was started in 1995 with admission of two candidates per year to eight candidates every year now.
• The journey of open-heart surgeries started from 3 patients per camp in the year 1986 and now nearly 1500 cases every year just before Corona period.
• The Department is having 3 Units and 14 faculty members.
• Department also running diploma in Perfusion Technology Course since 2013.
• The department has been performing all types of Cardiac, Thoracic, and Vascular Surgeries and having fully equipped 6 operation theatres and two post operative ICU in BMRC, 5 in CT ward.
• The department is also having the facility of Bronchoscopy.
• The department is also having the facility of Emergency Surgeries.
Dr. G.C. Sharma, MS, FACS,
FIAP (1924 to 2012)
He was a brilliant surgeon, outstanding teacher, kind at heart and a friend to all. He was trained as a Surgical Resident at Mount Sinai Hospital, New York, in 1951–52 and began his career in SMS Medical College & Hospital Jaipur. In 1959, he was once again selected for advanced training in the US, this time in famed Cardiothoracic Surgery Department at University Hospital, Ann Arbor, Michigan.
Back to Jaipur, he remained a Professor of Surgery and headed surgery department from 1963 to 1979. In 1975, he was appointed as a Principal and Controller of SMS Medical College and its associated group of hospitals, the post he held until his retirement in 1979. Post the retirement, he was recruited to serve as the Director of the Mobile Surgical Unit of Rajasthan state for 3 years, while continuing to serve as the Professor of Cardiothoracic Surgery.He died on June 9, 2012 just as he had wished to die, sans any fuss and formal farewell preceding to the grave to all those whom he loved and all those who loved him.
Dr. Goutam Sen
(HOD 1983 to 1991)
Awarded by life time achievement award by IACTS
Dr. Sen’s tenure the Open Heart Surgery was begun with proctorship of Dr. Devendra Saksena a legendry Cardio Thoracic Surgeon from Bombay Hospital.
Dr.D.Saksena
Cardio-Thoracic Surgeion Bombay Hospital proctored open heart surgery in SMS Hospital.
Walking down memory lane. . .by
Dr. Goutam Sen, Former Professor and Head CT Surgery, SMS Medical College Jaipur.
• Although Cardiothoracic Surgery had begun in SMS Medical College in a small way in 1964 post Dr. G C Sharma’s return from the U.S.A. He was bent upon to start all the lifesaving operations on the heart and lung that he came across.
• He also knew that he could not possibly do all this single handedly but was stilldetermined to do at least one surgical procedure every week. Although at times,even that was not possible. A dedicated team was required. Most young surgeons were reluctant to shift from their lucrative general surgery to thistime consuminguncertain specialty.
• In 1974 I joined his Surgical Unit which he had been divided intwo parts (The General Surgery Unit (2C & D) and CT Unit). In this area he kept a few special beds for the Cardiothoracic cases.
• He also felt that need of a space totally dedicated to Cardiothoracic Surgery. The New CT Ward was opened in 1979 on the third floor of the new block in SMS Hospital. It was spacious enough and had the capacity for further expansion. The two ten-bedded portions with administrative areas wereimmediately full. There were patients to be operated but not possible due to huge shortage of OT space.
• A large vacant area was then earmarked for CT Operation theatre and soon a complete theatre block with a good operation table lights and a sterilizer was installed.
• Thus the CT Unit was born.
• Dr. Goutam Sen, Dr.K.S.Yadav and Dr. Rama Kant Saxena were then sent on deputation to three different premier institutions of India to acquire the M.Ch. degree in Cardiothoracic and Vascular Surgery. Dr.Goutam Sen went to AIIMS New Delhi, Dr. Karan Singh to CMC Vellore and Dr.Rama Kant was trained in KEM Hospital Bombay(Now Mumbai).
• They all returned after two years with a M.Ch. degree but the surgical skills still needed to be honed as ‘Hands On’ experience was lacking at all the above training institutes. They were allowed to assist but independent work was nearly non-existent.
• Closed Mitral Valvotomies, Ligation of Patent Ductus Arteriosus, Pericardiectomies and Correction of Coarctation of Aorta were the operations done initially. These operations did not require the heart lung machine and a large team to go with it. As time passed, the need to get more practical experience was realised.
• Dr. G. Sen went on a Commonwealth Fellowship to the General Infirmary at Leeds (1981-82)in UK to work under Mr. Marion Ionescu(Oddly Surgeons in the UK were addressed as Mr.) He was pioneer in heart valve surgery. This skill was needed very badly to begin the Open Heart Surgery at Jaipur. Dr. Karan Singh Yadav was soon to follow for a year as a Commonwealth Fellow to Southampton (1983-84)to hone his skills.
• Dr. Sen after his return, was appointed Professor of Surgery (CT) with the sole charge of the CT Unit. With the encouragement of Dr. S R Mehta (The then dynamic Principal) a small amount of fund was given to purchase the heart lung machine, monitors and surgical equipments. The arduous task of creating a Cardiothoracic Department was on the way. With the fund of approximately rupees fourteen lacs a Sarns Heart Lung Machine, two (Three Channels) Siemens Monitors and some surgical instruments were purchased.
• It was fortuitous for us that Dr. Devendra Saxena from Mumbai was able to help us start Open heart Surgery and we began the ‘open heart’ era in SMS in 1984.We shall always be grateful to him for helping us.
• Under the able direction of Dr. Nirmal Sen, Professor of Anaesthesia, a small team became available exclusively for cardiac anaesthesia. Sister Annikutty and her OT staff were enthusiastic about this new programme. They needed to spend extra hours learning and practicing. This time they gave unstintingly. Mr Mahesh Pal and Mr. Kala Prasad were trained as Perfusionist and helped in the programme with great confidence.
• An ICU with at least three beds was required. Sister Rohini,Ratna and the team were soon deeply involved in creating a space next to the theatre with basic monitors and a Birds ventilator for two beds. Thus a small beginning was made.
• Once begun, there was no stopping. With the cooperation of Dr. V.S.Baldewa, Dr. S K Sharma, Dr. AmritKhalsa and Dr. R.K.Madhok a few operable cardiac cases began to trickle in.
• Besides being ready for surgery, there was need for close cooperation from various ancillary departments. The blood bank was required to arrange four units of fresh blood (fractionation came much later). Dr. NarainiChangani and Dr. Nanavati were in charge at that time. The donors would be identified earlier but the blood would be collected only on the morning of surgery so that the coagulation factors would be still fresh. Occasionally in case of post-operative bleeding much larger volumes would be required. It can be said with great pride that the blood bank accepted the challenge and was never found wanting. Medical students and doctors too would quietly donate blood for our patients.
• The other major contributor was the Biochemistry department. They were required to bring in us instant reports of blood, gas and electrolyte estimations. Dr. I.C. Sogani was very caring untill our own bedside laboratory under Dr. Soni was started in the room adjoining the ICU.
• Oddly enough the other department that played a major role was the electricity department. The supply would be erratic. A standby generator was available but it did not come on automatically. A direct cable from the generator to our OT and ICU had been connected. Whenever an operation in progress, an operator was deputed on constant duty near the generatorto start the generator as soon as the electric supply shut down. It was the job of the surgeon to personally and physically verify that he was on the spot before the surgery began.
• Being able to do surgery was only a very small part of the way to success. After such major operations for single or double valve replacement and various congenital defects (Atrial Septal and Ventricular Septal Defects) etc.) the outcome was dependent on post-operative care. The first twelve hours in those early days required constant attention. In the immediate two to three hours post the surgery there was constant danger of excessive bleeding. These patients had been heparinized and even small blood vessels would continue to bleed. Arrhythmia, hypotension and ventilator related problems were other issues to watch out for. In the beginning it was only the surgeon and anesthetist who would be capable of tackling these problems. Our nurses were not upto the task. They had to learn all the skills by watching us. They had also to be taught the theory behind the care of the cardiac patient.
• It was the accepted norm that the surgeon would stay with the patient till the next morning until he/she was more settled. It was only when a colleague was available the next morning that the surgeon would go home a quick freshening up before returning to the patient’s bedside.
• This process went on continuously dayin-day out in the initial years. Our social and family life was neglected, and joke came in vogue that cardiac surgeons in the world over had the highest divorce rate.
• It can be stated with pride that because of our dedication and hard work there was not a single mortality in our first hundred cases. At that time the mortality in bigger centres varied from 5-10%.
• It is not possible for the doctors who work in Cardiothoracic surgery today to imagine how hard all the staff had to work to create the foundation on which they function so smoothly today. It was the blood and sweat of their predecessors that has made it so easy for them today.
• I am told that the Cardiothoracic Department, SMS Medical College Jaipur conducts more than 1500 operations every year. In the time to come I am sure it will be one of the premier centres of the country.
Dr. Karan Singh Yadav
(HOD 1991 -1998)
Superintendent SMS Hospital
(1996 to 1998)
Dr. Karan Singh’s tenure:
Awarded by life time achievement award by IACTS
Exponential Growth of the department occurred under the headship
• 600 Open Heart Surgeries in a year
• 250 Thoracic Surgeries in a year
• 250 Vascular Surgeries in a year
• Addition of M.Ch. PG Training program.
• Recruitment of more faculties
• Commencement of Bangur Cardiac Surgery Premises
• Beginning of Coronary Artery Bypass Surgery
• Organised National Conference of Indian Association of Cardio Vascular thoracic surgeons (CT- CON 1998).
• Started G.C. Sharma fellowship under the banner of IACTS
• and many more… Achievement.
Dr. Naresh Trehan
Modern Era of Coronary Artery Bypass Surgery was started in 1993 with the patronage of, CEO and Chief Cardiac Surgeon of then Escorts Heart Institute, New Delhi under the headship of Dr. K.S.Yada.
Dr. Ramakant Saxena
(HOD 1998 to 1999)