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DEPARTMENT OF  SURGERY

INTRODUCTION:

             Civil Hospital start functioning since 1886, but the first  surgeon  Dr  K.K. Dey was posted in the  year 1971 after 85(eighty five) years of its  establishment by the  Govt. Of Assam. Dr K.K. Dey worked  for 6(six) months,  as Assistant Surgeon-1, and was given an option whether he  wants  to  join  the Assam Govt. or Union Territory, Mizoram as  Mizoram which was then one of  the District  of  Assam as  Lushai  District was uplifted to Union  Territory on 21st January 1972. So, he opted for Assam   and  then left civil Hospital.

             Dr R. Tlangkunga who after completion of Master Degree in Surgery from Dibrugarh Medical Collage , Assam  immediately joint Civil Hospital from February 1972 as Assistant Surgeon-1.Dr R. Tlangkunga starts building up the surgery Department establishing the Male and Female Surgical Wards and separate Operation Theatre. Dr  D.Baruah Joint the Civil hospital in the year 1978 after completion of  Master Degree in Surgery from Rohtak Medical  College, Haryana  and after working for some months  and he was posted to Lunglei, Civil Hospital, since 1979 and after  working for some years at Lunglei he came back to Aizawl Civil Hospital in 1982. Under Dr R. Tlangkunga, together with Dr D. Baruah many  major Operation were done and Surgery Department was improved in many ways.

               Dr Lalsanga after completion of Master Degree in Surgery from P.G.I. Chandigarh in 1988 April, join Civil Hospital Aizawl and he was immediately posted to civil hospital Lunglei. Dr K. Lalbiakzuala after completion of Master Degree in Surgery from P.G.I. Chandigarh join Civil Hospital Aizawl in 1988 Sept. Dr K. Lalbiakzuala work energetically for the improvement of the Department. The present Male and Female Surgical wards along with the Surgery Operation Theatre complex, New Building was completed in 1990 under the guidance of Dr R. Tlangkunga and occupied by the Department since then  till date. Dr Lalsanga was again transfer to Civil Hospital Aizawl, from civil Hospital Lunglei in 1992. Under the initiation of Dr K. Lalbiakzuala, Surgery Dept. was separated into two  units in july 1992. Dr R. Tlangkunga the then Medical Superintendent Headed the unit-1 along with Dr K. Lalbiakzuala, and Dr D. Baruah  Headed the unit two-11 along with Dr Lalsanga.They work  unitedly, and led to improvement of the Department in many ways. Dr Lalhminghluta(R.I.P) after completion of master Degree in Surgery from Regional Institute of Medical Sciences , Imphal, Manipur,  join the Surgery Department in 1993 and immediately posted to Lunglei Civil Hospital.  Dr R. Tlangkunga was the first Head of Department and Dr D. Baruah took over the Head Of Department since 1990. Dr Lalsanga was again transfer to Civil Hospital Lunglei in 1995 and the Surgery unit was re-group as Dr D. Baruah as head of Unit-1, and Dr K. Lalbiakzuala as head of unit-11.Dr K. Lalbiakzuala lead  as Head of Department since 2000, when Dr. D.Baruah was promoted to Medical Superintend.

SURGEONS WHO HAS WORKED IN THE DEPARTMENT OF SURGERY:

-

DR SAIA CHENKUAL M.S. since 1996 july till date and H.O.D. since Nov. 2011 and Head of Unit-11,

-

DR THOMAS  ZOMUANA, M.S; D.N.B. since 1997sept till date ,now CONSULTANT,

-

DR STPHEN L. SAILO, M.S; M.ch(Urology) since 1999 to 2004

-

DR S.T. LALRUATFELA, M.S; Since January 2000 till date, now CONSULTANT,and Head of Unit-1,

-

DR BIAKLUNA M.S;(R.I.P) completed M.S.(Gen. Surgery) in 2002 and worked at District  Hospital, and join Surgery Department in 2004 to 2009,

-

DR C. LALROSANGA M.S; Completed M.S.(Gen.Surgery) in 2004 July and after working for some months in the Surgery Department posted to District Hospital  till date,

-

DR LALROCHUNGA M.S; Completed M.S.(Gen.Surgery) in2005 and worked in District Hospital, and join Surgery Department in February 2006 t0 August 2006 and again work at District Hospitals,

-

DR VANLALHLUA M.S. Completed M.S.(Gen.Surgery) in 2007 July and join Surgery Department since November 2007 to 2009 July and then posted to District Hospital  till date,

-

DR ZOTHANSANGA RALTE, M.S. Completed M.S.(Gen.Surgery) in may 2009 and join the Surgery Department till date,

-

DR LALHMINGMAWIA, M.S. Completed M.S.(Gen.Surgery) in May 2009 and join the Surgery  Department till 2012 November and now  posted to Falkawn Referral Hopital.,

-

DR LALRINSIAMA M.S. Completed M.S.(Gen.Surgery) in May 2011 and join the Department for some  months and transfer to District Hospital, Now studying Mch in Paediatric Surgery,

-

DR SAMUEL LALRUATFALA SAILO, M.S. Completed M.S.(Gen.Surgery) in October 2012 and join the Department till date.

-

DR C. LALHMANGAIHZUALA M.S. Completed M.S.(Gen.Surgery) in October 2012 and join the Department till date.

 

PRESENT  STATUS AND FUTURE PLANNING:

 

1.

No of Units

I & II

 

2.

No of Beds

39 Beds (MSW- 16, FSW-16, MMW-7)

 

 

 

 

PRESENT  MAN POWER:

 

Two  consultant   each and one  specialist each on both unit.(one specialist under  NRHM)

 

one medical officer (MBBS)

 

one  research  officer.(MBBS  under ICMR  Dibrugarh)

 

one social worker. (MSW under ICMR Dibrugarh)

 

 

 

 

WARD  STAFF:

 

 

MSW:- 1(ONE)Sister Incharge

 

 

5(FIVE) Staff Nurse (Rotating for 24Hrs.)

 

 

FSW:- 1(ONE) Sister Incharge

 

 

5 (Five) Staff  Nurse (Rotating for 24 Hrs.)

 

 

GRADE 1V:- 1(ONE) MSW, FSW, MMW.

 

 

SWEAPER :- 1(ONE) MSW, FSW, MMW.

 

 

 

WORKING  CONDITION :

 

1.

OPD:-   Daily on working days.

 

 

UNIT I

Mon.; Wed.;  Fri.

 

 

UNIT II

Tue.; Thurs,; Sat.

 

 

 

 

 

2.

O.T :- Daily on working days.

 

 

UNIT I

Tue,; Thurs.; Sat.

 

 

UNIT II

Mon.; Wed.; Fri.

 

 

 

 

 

3.

Emergency  Operation:-  Daily on every day  (24 Hrs)

 

 

 

 

4.

Minor operations:- Daily on  working days.

 

 

 

EQUIPMENTS:

 

Male Surgical Ward (MSW):

 

1.

SUCTION MACHINE

- 1

 

2.

NEBULIZER  AND STEAM INHALATION

- 1(ONE)  EACH

 

3.

WEIGHING  MACHINE

- 1

 

4.

FRIDGE

- 1

 

5.

GLUCOMETER

- 1, NO STICK

 

6.

COMPLETE SET OF OXYGEN

- 1

 

7.

EXAMINATION TABLE

- 1 (N0T FUNCTIONING  WELL)

 

8.

B.P. INSTRUMENT

- 1

 

9.

STETHOSCOPE

- 1

 

10.

THERMOMETER

- 1

 

11.

AMBU  BAG

- 1

 

12.

DRESSING INSTRUMENTS

SCISSOR, STICH REMOVAL SCISSORS, ARTERY FORCEPS, TRAYS AND CLIP  REMOVAL.

 

 

 

 

 

Female Surgical Ward (FSW):

 

 

1.

SUCTION MACHINE

- 1

 

2.

NEBULIZER AND STEAM INHALATION

- 1 EACH(NOT FUNCTIONING)

 

3.

WEIGHING  MACHINE

- 1

 

4.

FRIDGE

- 1

 

5.

GLUCOMETER

- 1 No stick

 

6.

COMPLETE SET OF OXYGEN

- 1

 

7.

EXAMINATION TABLE

- 1 (N0T FUNCTIONING  WELL)

 

8.

B.P. INSTRUMENT

- 2  (ONE  NOT FUNCTIONING)

 

9.

STETHOSCOPE

- 1

 

10.

THERMOMETER

- 1

 

11.

AMBU   BAG

- 1

 

12.

DRESSING INSTRUMENTS

SCISSOR, STICH REMOVAL SCISSORS, ARTERY FORCEPS, TRAYS AND CLIP  REMOVAL.

         

 

ACHIEVEMENTS  OF DEPARTMENT OF  SURGERY,

CIVIL HOSPITAL, AIZAWL.

LAPAROSCOPIC SURGERY:

 

We  have organised a workshop on single port cholecystectomy and  laparoscopic hernial repair and we  have also done laparoscopic inguinal hernial repair by ourselves. To do single port laparoscopic cholecystectomy we need to acquire some hand  instruments so that we can also do this surgery by ourselves.

 

 

 

We have successfully done some advance laparoscopic  surgeries like  Laproscopic subtotal cholecystectomy and laparoscopic common bile  duct stone removal. Besides these we  are routinely doing laparoscopic cholecystectomies, appendectomies and diagnostic laparoscopic examinations and  biopsies. We  need to do more of the advance laparoscopic surgery like  gastrectomy, hemicolectomy  and VATS , for this we  need to improve our  instruments.

 

 

PAEDIATRIC  SURGERY:

 

Duhamels Pull Through operation for Hirschprung’s disease one of the most common Anorectal Malformations in Paediatric age group of Mizoram is done routinely since 2010

 

 

 

PSARP (Posterior Sagittal Ano Recto Plasty) for Recto Vestibular Fistula, another common ARM is also routinely done.

 

 

 

Thoracotomy and repair of Trache-0esophageal Fistula (TOF)  was attempted a few times without success due to lack of NICU and Noeonatal Ventilator. The first Successful TOF repair was done in 2010 after installation of Neonatal ventilator.

 

 

 

All other routine paediatric surgical procedures such as herniotomies, circumcisions, orchidopexies etc are done everyday.

 

 

PLASTIC SURGERY:

 

The department is routinely doing cleft lip/palate surgery. Flap repairs for tissue defect of different parts of the body is also routinely done. Skin grafting using both split skin and full thickness graft for burn and all types of raw area  are also performed regularly. Z-Plasties for different types of wound contractures are done with good results.

 

 

NEUROSURGERY:

 

Life saving Emergency Neurosurgical procedures such as Craniotomies for EDH and SDH are done. VP Shunts for Hydrocephalus is also performed every now and then.

 

 

UROLOGY:

 

The department is routinely doing Ureterolithomies, Pyelolithotomies, etc. for stone diseases of the urinary tract.

 

 

 

Nephrectomies for both malignant and benign diseases of the kidneys and open surgery for disease of the prostate and urinary bladder tumours are also done regularly.

 

 

 

Uro-plastic procedure a very delicate surgery such as pyeloplasties, urethroplasties , surgery for hypospadias etc are also done regularly  with good results.

 

 

 

Endourology  (Ureterorenoscopy, cystoscopy, etc.) which is the latest trend in urology is also performed in a handicapped manner due to lack of endourology instruments in the department.

 

 

EMERGENCY SURGERY:

 

All kinds of emergency surgeries are routinely performed by the two functioning units of surgery department. These include  Intestinal perforations/obstructions, Appendicitis, Intussusceptions, Liver/spleen/bowel and other solid organ injuries due to blunt traumas, stab injuries, gunshot injuries, etc.

 

 

ONCOLOGICAL SURGERY:

 

All kinds of GI Oncological surgeries are performed regularly in the department such as:

 

-

D2 subtotal gastrectomy/Total gastrectomy for Cancer of the stomach.

 

-

TTE (Trans Thoracic Esophagectomy) for Cancer of the oesophagus.

 

-

THE (Transhiatal Esophagectomy) for cancer of the oesophagus.

 

-

APR (Abdomino perineal Resection)for cancer of the rectum.

 

-

LAR (Low Anterior Resection) for cancer of the rectum.

 

-

Hemicolectomy (Right of Left) for cancer of the colon.

 

-

TAE  (Thoracoabdominal Esophgectomy) for Cancer of the GEJ

 

-

Resection anastomosis for small bowel tumours (rare)

 

-

MRM (Modified Radical Mastectomy)for cancer of the breast

 

-

Thyroidectomy ( all kinds) and Neck Dissection for Cancer of the thyroid

 

-

Penectomy for cancer of the penis

 

-

Resection (open) of bladder tumour

 

-

Radical Nephreterouretectomy for Cancer of the Kidneys

 

-

Excision with flap repair for all kinds if skin and soft tissue tumour( eg. Basal Cell carcinoma, Squamous cell carcinoma, etc.)

 

 

 

The oncological surgeries done in our department is at par in quality/standard and quantity with other parts of the country. Surgery department CHA,is probably the hospital perfoming the highest number of cancer surgery ( especially Cancerof the stomach and oesophagus) when compared to the other North East States.

 

 

 

FUTURE PLANNING; DEPARTMENT OF SURGERY

Surgery is a busy department with ever increasing workload. We have been working under the same available facilities for  more than 20 years. As patients are increasing and their expectations from us are increasing, we as surgery dept, need to have improvement in many areas. Some of our visions for the near future are:

 

 

 

1.

Increasing bed strength to 100 beds & to have 3 units.

 

At  present we  have 32+7 beds, and 2 surgical units, which is very less to  meet  the present demand. If we  can increase the bed strength and  surgical unit as above, patients can  stay  more days in hospital and there will  be less  waiting time for  routine surgery. This involves  increased manpower and hospital expansion.

 

 

2.

Emergency OT  with complete separate instruments  and equipments.

 

We need to have separate clean routine OT  room and septic emergency OT room. At present  we use our OT room for  both routine  and  emergency  cases which is not and ideal condition. We  vision to start renal transplant in our department  with the support of our medical and pathologist colleague as there  are many  cases of chronic renal diseases who needs regular dialysis. If we have an ideal OT and with little extra devotion and training we vision to start renal transplant.

 

 

3.

State of the art laparoscopic instruments set.

 

Laparoscopic  surgery/pin hole surgery is the common  method of  surgery now- aday. Patients want less pain, less hospital stay, less  scar and early  recovery. Laparoscopic surgery is  the answer. We vision to develop  this   art. In order  to  do advance laparoscopic  surgery we demand high  definition 3 chips camera with high definition monitor with light source and complete  hand  sets.

 

 

4.

Minimal invasive urological instruments such as, TURP set, URS set ,         PCNL set  with latest ultrasound or laser lithotripters.

 

Minimally invasive  surgery is  the preferred method in many urological procedure than the old open  method. If  we  can  have  this equipments  it  will  be  a great benefit  for the patients  and to  the people of  Mizoram. We  need little  exposure and training since  we do not have trained  urologist  at present.

 

 

5.

Surgical Intensive care unit and high dependency unit with separate        trained staff.

 

Our Hospital is  now having one ICU where all  cases of  patients  are kept. It  so  happened  in  many  occasion  that  we  can not keep our post operative patient who  need  an  ICU. Many  occasion  we  have  to cancel or postpone  the  surgery  which  we have  planned before  which  cause  many  inconvenience to the  patient and  surgeon, so we  vision to  have  separate  surgical ICU and high dependency ward for  surgery department.

 

 

6.

Surgical Day Care unit.

 

Many major  surgical  procedure  can  be treated in a day  care  basis e.g. Hernia, piles surgery,  diagnostic laparoscopic procedure and  many  more  if we have well  recovery room and staff  attached to it. This  will  reduce  the ward  admission and  thus  reduce ward  burden.

 

 

7.

Annual training programmes for super-speciality disciplines for surgeons.

 

Medical profession  is constantly  changing and need constant update and education to stay in our profession. Every surgeon should go for training  as  need  base and  attend conference if opportunity arises ,  and even abroad. We  vision separate budget for training annually.

 

 

8.

Increasing the number of House Surgeons and Medical officers in the department.

 

We  feel we  are losing  opportunity due lack of man power. If we have more  medical  officers  as Research Fellow we can use  them for  collecting our data and  analyse our  data for  references  and publish in journals. We  vision separate  budget for this.

 

 

9.

To conduct regular training programmes for Medical Officers posted at PHCs and CHCs.

 

Instead of posting our specialist surgeon to district hospitals  where no anaesthetist or OT facilities are  available we  can  conduct  regular training programme so  that they  can handle  and  manage surgical  emergency  cases at their respective posting hospital. This will increase the man power at the  civil hospital.

 

 

10.

Staff Quarters for emergency duty doctors/staffs.

 

Unless  we  have quarters for emergency duty  doctors and resident and staff our  emergency service will never be satisfactory and  prompt .We  vision to  have quarter  near by  the hospital.

 

 

11.

Separate Instrument set for each operation.

 

 

12.

To conduct regular inter-department meeting viz       Radiosurgical Radiooncology, Surgicopatho etc.

 

 

13.

To have a separate running office for the Department and Separate        rooms for HOD and Heads of Unit.

 

 

14.

Library with internet facility.

 

 

15.

Regular and adequate supply of sutures and surgical disposables.

 

 

16.

Annual maintenance contract for  all the  sophisticated instruments.

 

 

CONCLUSION

 

THE   DEPARTMENT OF SURGERY IS ONE  OF THE BUSSIEST  AND  OVER  WORKED  DEPARTMENT,  THERE  IS  SHORTAGE OF  MANPOWER , ( DOCTORS AND STAFF, TECHNICIANS AND  GRADE IV. ETC.)  BEDS , EQUIPMENTS AND  FACILITIES. IT  CANNOT  MEET  THE  PRESENT  NEEDS  AND  DEMANDS  OF  THE  POEPLE, WHO  DESERVE  THE  BEST. SO IT  HAS TO  BE ENLARGE  AND INCREASE  ITS MANPOWER  AND  FACILITIES IN EVERY  DIRECTION.  THE  PRESENT LOCATION HAS IN  NO WAY,  HAS  THE  SPACE AND   CAPACITY  TO  MEET  THE  FUTURE  NEEDS  AND  DEMANDS OF  THE PEOPLE.  IT  IS CONGESTED AND  OVERCROWDED. SO IT  HAS TO  BE  SHIFTED  TO  A  PLACE  WHERE  THERE IS  ENOUGH  SPACE  FOR  THE  FUTURE  DEVELOPEMENT OF  THE  DEPARTMENT.  THE  BEST  WAY  TO  MEET  THE  FUTURE  NEEDS  AND  DEMANDS  OF  THE POEPLE WOULD   BE TO ESTABLISHE  A  WELL  DEVELOPE AND  EQUIPPED  MEDICAL  COLLEGE  AS  EARLY  AS  POSSIBLE.

 

SURGERY  IS TEAM  WORK. WITHOUT   THE  BACK  UP OF  TEAM  OF GOOD  PATHOLOGIST, RADIOLOGIST, ANAESTHETIST, I.C.U. GI ENDOSCOPIC  UNIT AND OTHER  INVESTIGATIVE MODALITIES, IT  CANNOT  FUNCTION  WELL. SO ALL THESE DEPARTMENT  SHOULD BE WELL DEVELOPED TOO.

 

 

 

 

 
 

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