Robotic Surgery -The Change Makers in Minimally Invasive Surgery in Andhra Pradesh and Telangana- The team which introduced dAVinci Si, Si HD and X in Telugu States.Minimally Invasive Surgery should be the natural intuitive extension of Surgeon’s fine finger movements with devotion to quality and safety

OUR JOURNEY OF 3,000 ROBOTIC SURGERIES

It’s been a passionate journey for me , a dream fulfilled for our team in the field of Robotic Assisted Surgery in Hyderbad. We started on June 11th,2011 with training by Dr. Dan and Dr. Peabody from USA at Krishna Institute of Medical Sciences. It was the first case in Hyderabad with Si on that day. After that I did my first Robotic Surgery a case of carcinoma Esophagus. I called Mr.Srinivasan of Intuitive for any videos done earlier but he said they don’t have. I used the knowledge of thoracoscoic esophagectomy and completed the case successfully by robotic equipment. I felt like walking in clouds that day and my journey started ever since.  We were in Yashoda Secunderabad before that and shifted to KIMS for the love of Robotic Surgery even though we were paid higher there. Technology always drives us and will do so every time.  We were anxious as we had left excellent practice in Yashoda but our dream of doing robotic surgery was achieved.

Many of my friends felt I was mad to take up Robotics as it doesn’t work out financially and is expensive. But my heart always beats for robotic surgery and was prepared to work for lesser salary to achieve my goal. Ironically the same friends who criticised me for taking up robotic surgery shifted to practising it and buying the machine. Our practice picked up fast and Dr. Bhasker Rao sir, MD was  instrumental in bringing the first robotic system to undivided Andhra Pradesh that time.  I am indebted to Dr. Bhasker Rao sir for allowing me to practice robotic surgery. He is a visionary. We had a scheme in KIMS where we had to pay one lakh to company no matter how many cases we do in a day. So we started doing 3 to 4 cases a day and our numbers started increasing. Then I went to USA,Rose Well Park Cancerr Institue and did my fellowship there in Robotic Surgery. I never had a passport and never travelled, my love of Robotic Surgery took me there and it improved my robotic skills, met many exemplary Surgeons and upgraded my skills. And also fulfilled my another wish of visiting Niagara Falls which was near to my training Institute.

And came back ,started operating and  with Dr. Vikas, Dr. Arun soon completed 100 Robotic Surgeries a first in erstwhile Andhra Pradesh.

Even though we perform complex surgeries it is important to see and interact with Surgeons across the World as it will help us to know if we are on the right path and we are doing a good job in treating patients who expect a lot from us. So in June 2012 I went to the best  Robotic Institute in the World,Severance Robotic Institute in Yonsei University,Seoul. It was my first visit to Korea was scary as very few speak english in Korea. But soon I learnt that Koreans are very humble, respectful to everyone, talented and futuristic. They are almost 10 years ahead. First time I regretted for not visiting Korea earlier. I perfected my Robotic Surgery skills especially in Colo Rectal and Neck Scar less Thyroidectomy

Severance Robotic Institute changed me and made me more humble, more hungry to learn, not bother about petty things and focus on surgery. And later I became a International faculty thrice and it was my honour to have delivered lecture and won best paper awards in annual meets twice.

Krishna Institute of Medical Sciences Robotic surgery department grew rapidly with training programs every month and various conferences with celebrities like actor Nagarjuna, my teachers, students. Conducted National and International Robotic conferences. Robotic Surgery has become established in Hyderabad. Other Surgeons started coming to us for training.

I remember when I started my practice I asked a freind of mine that I want to visit his center and learn Laparoscopy, but I was ignored or he was busy and forgot. Then I decided to learn on my own. Internet was my biggest teacher and learnt many skills online but had to shell down lot of money and affected my bank balance. I decided if I get a chance to teach I will do free hands on training which is important to create more Surgeons who will create still more. then I visited many centres across the World to know if I am doing correct treatment.

I visted Hamburg, Germany for Trans Anal TME for rectal cancer and met a dynamic Surgeon from UK Dr. Manish Chand

Went to Seoul national University Hospital for PIPAC training

Went to Chaim Shiba Cancer Institute,Tel Hashmore, Israel for HIPEC training April 2017 and met Dr. Aviram Nissan. They are very hard working, high tech and meticulous.

I visited Jerusalem from there and didn’t realise the importance of the place until I walked along the path Lord Jesus was taken. It hit me strong seeing the holiest place and can never forget the impact.

After seeing Churches, Mosques and Temples I realised God is a force used by some people for their personal agenda and God never discriminates region, religion or caste and creed. He gave us freedom to think and follow, its we who manipulate to our own beliefs or some for self gains. I realised I am a small person or minuscule in this universe and should never fall into the trap of discrimination.

We started doing free hands on training laparoscopic and Robotic programs on our own. I got a chance to become Hon. Secretary of Association of Surgeons of India because of very good friends and Seniors. It gave a platform to teach many Surgeons especially students and free of cost. We crossed 100 academic programs real site and online and will strive to do more. And another opportunity came as a founder member of CRSA India Chapter.

Our students became teachers. But the World of Robotic Surgery was expanding and there is more to achieve, more Surgeons to train. And as new machines started coming I had to join Yashoda to start a new Robotic Program with the latest Robotic at that time. We trained more than 20 Surgeons in Yashoda and annual Minimally Invasive Onco Surgery workshops called MIOS our flagship program. Dr. G. S.Rao sir has taught me how to practice,. Has always appreciated my work and I completed my contract period successfully. I will always respect Dr. G. S. Rao sir for his kind support. And we crossed 3,000 robotic surgeries overall. Only once I was scared. It was post covid thoracic case and we underestimated Covid inflammation as Covid is a new disease for us. All vessels were supple and the Pulmonary Artery gave way and started bleeding, I clamped it with Cardierre and opened chest in few minutes and controlled the bleeding and patient went home. Concerting thoracic robot to open is the most dangerous game for window and we need to be real fast. Now we wait 2 months for post covid thoracic cases. I could not sleep for 3 days and I thank God for helping control my senses during crisis.

Became International Faculty

Met the living legend Dr. Pratap Reddy sir who offered me job at Apollo , Jubilee hills. He is a great man who developed health care in South India. He and Madame Sangeetha Reddy garu gave me an appointment letter but when went down to meet two other persons,one asked me not to join and other gave me cold looks as I came directly from Chairman. Then I decided I can’t afford to have friction in working place and can’t go to Chairman for day to day affairs.

In our pursuit of Robotic Surgery became Robotic procter for many Institutes like AIIMS, Hrishikesh,AIIMS, Jodhpur,SGPGI, JIPMER, Apillo Delhi,Fortis, Mumbai, Hinduja, Nanavati, HCG,Kovai, etc. My heart skipped when my teacher called me to initiate Robotic Program at Yenopaya University,Mangalore. I was fortunate to have met so many illustrious luminaries across India and other Countries. I thank God for having got such opportunities and my parents who provided me atmosphere to study and took care of me during my education especially my Dad who never said no to me. I went into depression for a year after I lost him. I also give credit to my teacher Late Shri. Shiva Rama Krishna and my cousin who guide me during my MBBS coaching, a great moral police man and guide to many.

I was invited by Hon. PM Modiji as a panelist with illustrious personalities in VAIBHAV on Intelligent devices,Robotic technology theme,an innovative program launched by Hon. PM, Modiji. Hope my dream of affordable Robotic Surgery equipment in maden in India. Excellent inputs hy faculty across the World #आधुनिक शल्य और रोबोट सर्जरी प्रौद्योगिकी सभी के लिए #RobotReachRural #jagdishwar #roboticoncosurgery

As our journey was continuing humanity and we were suffering the pandemic effects of Covid 19. I pray that people across continents recover from it.

As we were deep in the highest technology, my duty to society was always there. Since 18 years I have visited Mahboobnagar, Nizamabad, Adilabad, Siddipet, Kurnool, Warangal, Jagityal, Armoor, Medak, Zaheerabad, Gulbarga and especially Karimnagar my second home. I used to operate in these places and never ever counted how much they paid. Only once I saw that thad just Rs. 2000 as it was a single note. My greatest gratitude is to Karimnagar and Jagityal,people there and doctors have always supported me. We did thousands of surgeries and many in arogyashree in Shushruta hospital. Shushruta management didn’t recognise our service and without informing us just handed over to another group, but people of Karimnagar do remember us and many of them bless us whenever I meet them. It changed me too and I will always dedicate myself to people and technology. After Covid pandemic it has become difficult to travel now. I miss Karimnagar a lot.

But our pursuit of newer Robot and newer robotic program continues and I was always driven by technology. I feel in our short life on this earth we should train maximum no of people possible, maximum no of hospitals possible and work with the latest Robot. I know I have hurt some administrators during this pursuit of mentorship and operating with latest technology but it fulfilled our goal of training many Surgeons and being updated in Robotic technology. In this journey again we now have joined American Oncology Institute as National Head of AOI Robotic Program and will soon get to operate on latest and a first in Telugu states the X DaVinci Robot. The Institute has an International Tutor board to discuss complex cases, 4 K and ICG laparoscopy equipment, a dedicated HIPEC machine and facility to do Sentinel LN Biopsy. Advanced facilities like this make a difference in patients life give better quality and cure at the same time.

We promise to keep ourselves updated in surgical technology and will go wherever advanced facilities are available to better the life of cancer patients. I seek forgiveness if I have anyone during this journey and also some of my dear friends and family members whom I could not give time.

Dr. Jagadishwar Gajagowni Goud

National Head,AOI Robotic program

HOD Dept. of Surgical Oncology

American Oncology Institute, Nallagandla

Hyderabad,Telangana