EHS-COVID (365) Impact of COVID-19 on elective (non-urgent) surgery (5)

1 June, 2021

Dear HIFA Members and Dr. Meena Cherian

Thanks for the articles about Surgeries especially Laparoscopic surgeries during the Pandemic. The Gas Less Laparoscopic Surgeries especially for surgeries like Appendicectomies and Pelvic surgeries which are possible with Single small Umbilical incision has advantages due to the isobaric system, the ability to continuously use suction, and the possibility of surgeries under spinal anesthesia

During the Pandemic most of the rural hospitals in India did the following

1) Stopped all Surgical Work

2) Later re-started with Only Emergency Surgical work

3) When the urban hospitals were overwhelmed only the rural hospitals were available for elective surgical work.

Many hospitals doing Laparoscopic surgeries especially in the urban areas reported that the Operating Room [OR] staff were getting infected. This made the rural hospitals do elective surgeries either with Open surgeries or when facilities are available by Gas Insufflation Less Laparoscopic surgeries [GILLS].

It is also good to note that although few none of the rural hospitals performing GILLS had Covid infection among the OR staff.

HIFA profile: J Gnanaraj is an Urologist and laparoscopic surgeon trained from Christian Medical College, Vellore. He is currently the Director of Medical Services of SEESHA which is a social service wing of the Jesus Calls ministry. He has upgraded the facilities at the Karunya Rural community hospital at Karunyanagar to a center for minimally invasive surgeries and started the heath care plan and the master heath check -up and the outpatient clinic at Coimbatore. He designed C3MDS the hospital management software along with computer personnel and designed local modifications and installed it many mission and other hospitals. This is being upgraded to a web based version compliant with the requirement of the National Accreditation Board for hospitals and health care facilities in India. He has designed low cost medical equipment for use at the mission hospitals and doing research on medical equipment in Karunya University. He is the Editor of the Rural surgery Journal of the Association of rural surgeons of India and has 45 publications in national and international Journal. He has presented papers at the conferences of Association of Surgeons of India (Calcutta, Cuttack and Madras), Urological Society of India (Bangalore & Nagarjunasagar), Association of Southern Urologist of India (Ooty & Vellore), Indian Medical Association (Trichy), Rural Surgery (Sivakasi, Ujjain, Sewagram), Association of surgeons of Assam (Silchar), International Federation of rural surgeons (Ifakara, Tanzania), WHO CME for rural surgeons (Herbertpur), International College of Surgeons conference (Trichy). He has organized many innovative diagnostic and surgical camps at interior rural places in India.