Introduction
SVIMS: Inception
SVIMS was conceived in the year 1986 and the
foundation stone was laid on 18th April 1986 by late Sri. N.T. Rama
Rao, the Hon'ble Chief Minister of Andhra Pradesh (A.P.) It was
established with a view to providing super-specialty facilities with
nominal cost to the poor. The hospital started functioning from 26th
February 1993 by an Act of A.P. State Legislature a. In 1995, SVIMS
became a University. In 2006, SVIMS was upgraded to a status at par
with AIIMS, New Delhi, under the Pradhan Mantri Swasthya Suraksha
Yojana scheme of Government of India. SVIMS is recognized by Medical
Council of India, for starting various MD/DM/MCh medical courses
since 2003. Sri Padmavathi Medical College for Women and associated
hospital were established in the year 2014 with an annual intake of
150 students for the MBBS course. It is the second government
medical college in India exclusively for women students. In 2018,
SVIMS was ranked among the top 100 Higher Education Institutions in
India (National Institutional Ranking Framework [NIRF] rank 62 among
Universities
Department of
Neurosurgery: the Beginning
The Department of Neurosurgery at Sri
Venkateswara Institute of Medical Sciences was started in September
1993 by Dr C.V. Ravi Kumar, an alumnus of NIMHANS Bangalore.
The primary mission of this department is to
deliver high-quality neurosurgical care to the needy. As the
workload increased, the faculty has been strengthened by
neurosurgeons trained in some of the premier centers in India. The
department caters to the people of Rayalaseema in particular and
also gets referrals from the entire Andhra Pradesh, and the
neighboring states of Tamil Nadu and Karnataka. Subsequently, the
following faculty members joined the department (in order of
joining): Dr. Arun K Singh, Dr Ravikanth Palur, Dr. B Ravi Mohan Rao,
Dr S Satish, Dr. GR Chandrasekhar, Dr Satyendra Kumar, Dr D
Radhakrishna Reddy, Dr K Ganesh Murthy, Dr P Pandurangan, Dr. G
Prakash Rao, Dr Suresh Naik, Dr B Kishore Swain, Dr JV Bhusan, Dr
Ravi Suman, Dr K Chandra Sekhar, and Dr A Anil Kumar
Department of
Neurosurgery: the Era of Dr BCM Prasad
The evolution of the Department of Neurosurgery
at SVIMS can be divided into two periods, the era before and after
the advent of Dr BCM Prasad Dr BCM Prasad is an alumnus of Andhra
Medical College and NIMHANS Bangalore. He was appointed as Professor
and Head of the Department at SVIMS in 2007 and was entrusted the
task of developing the residency program. Dr BCM Prasad with the
help of an efficient team of assistants, Dr T Suresh, Dr KS Kiran,
Dr G Vara Prasad, Dr E Srinivasa Rao, Dr P Maheswar Reddy, Dr VV
Ramesh Chandra, Dr A Sasidhar, Dr V Ravikanth, Dr D Jagdeeswara
Reddy, Dr Kiran, Dr Jayachandra, Dr Jagadeesh, Dr Sanjeev, Dr Sidda
Reddy, Dr Krishnamohan, Dr V. Niranjan, Dr K Venkat, Dr Sudarshan,
Dr Sasank, and Dr Srikanth catapulted the department to a new high.
Dr Ramesh Chandra, an alumnus of JIPMER
Pondicherry and PGIMER Chandigarh joined the department as Assistant
Professor in 2009. Dr BCM Prasad constantly supported, encouraged,
and nurtured his career, gave him an opportunity to partake the
responsibility of developing the department into its present form.
The mentor–mentee relationship and the mutual understanding between
them did wonders for the development of the department
The other members of the present faculty include
Dr Niranjan, an alumnus of Osmania University, Dr Venkat, an alumnus
of AIIMS Delhi, and Dr Srikant, an alumnus of SVIMS Tirupati .The
department has made great strides forward since then, in rendering
modern neurosurgical services to patients. With the acquisition of
state-of the-art equipment, it has evolved into a full-fledged,
neurosurgical center in the state of Andhra Pradesh.
Patient care
The department runs regular outpatient clinics on
Monday, Wednesday, and Friday. The total bed strength is 50. The
department has two well-equipped operation theaters functioning all
around the year, with 100–150 surgeries being performed per month.
The clinical services under Dr BCM Prasad were
streamlined and the concept of sub-specialization was introduced.
With the implementation of various health insurance schemes like
Rajiv Aarogyasri/NTR Vaidyaseva and Pranadanam, the patients
attending the outpatient department and the surgeries performed
increased three folds. The quantity and quality of the neurosurgical
work done at SVIMS were recognized by the Andhra Pradesh government
and it was awarded the “Best Neurosurgery Department” state award
for 2018
The department caters to a huge population and
comprises several clinical programs that encompass the entire
spectrum of neurosurgical practice. The programs unique to SVIMS
which are available at very few neurosurgical centers are the
minimally invasive spine (MIS), spinal deformity and deep brain
stimulation (DBS) programs.
The MIS program was developed to be at par with
any international center. The program boasts of performing all the
minimally invasive spine (MIS) procedures described in the
literature. The center has been identified as a visiting surgeon
program center for MIS and it trains surgeons interested in these
procedures.
The Department started the spinal deformity
program in 2013 with the help of Dr HS Chhabra from Indian Spinal
Injury Centre; Delhi. The department has treated independently
around 120 patients with various deformities under this program.
This is the only center in Andhra Pradesh with a dedicated spinal
deformity program offering treatment to a large number of patients
regularly. The work done on spinal deformity was presented as
“Development of the surgical program for spinal deformity at a
tertiary center – challenges and outcomes” at the British Medical
Journal South Asia Awards 2017 and was selected as a finalist under
the category “Surgical team of the year”
The departments of neurosurgery and neurology
started the movement disorder program in July 2017. Dr Anandh
Balasubramanian and Dr Kiran Khanapure were the proctors for the
initial cases to transfer the technical know-how for deep brain
stimulation (DBS). The department has independently and successfully
treated 25 patients with DBS till now. This is the only center in
Andhra Pradesh offering DBS and conducted the first-ever “Live DBS
workshop for Parkinson's disease” in India. Around 150 neurologists
and neurosurgeons participated from all over the country and made it
a huge success.
The movement disorder and the spinal deformity
programs are good examples wherein the quality healthcare reaches
the financially weaker section of people without any financial
burden to them. The huge success of these programs received
extensive media coverage and reached out to a lot of poor patients.
Academics
The residency program (MCh Neurosurgery) was
properly structured and the intake of residents increased from one
student per year to three per year. Till now, a total of 19
residents have been awarded MCh degrees. The academic activities
were streamlined and the proper protocol was followed in line with
that of the best institutes in the country. Interactive teaching
sessions including neuroradiology sessions, seminars, journal clubs,
preoperative discussions, morbidity-mortality meets, and case
presentations are regularly conducted for the MCh Residents. The
neurosurgical work done at SVIMS has been accepted and presented at
various international (ACNS, Global spine congress, Worldspine,
SMISS, etc) and national (NSICON, SPINE, ASSICON etc) conferences.
The faculty and the residents bagged some prestigious fellowships to
enhance their exposure to various subspecialties.
Research
Apart from the many projects done on conventional
neurosurgical topics the department has ventured into research into
basic neurosciences. In vitro differentiation of cultured human CD
34+ cells into astrocytes was done. We identified novel NF1 gene
mutations in three different neurofibromatosis type 1 Indian
families, novel mutations were identified in sequence analysis of
NF2 and TRAF 7 genes in meningiomas. All the sequence variants
identified herein have been deposited in the GenBank (http://www.ncbi.nlm.nih.gov/Sequin/).
Conferences/CME/Orations
The department conducted the annual state
conference of the Andhra Pradesh Neuroscientists Association (APNSA)
in 1996, 2003, and 2014. Two orations are conducted every year, the
Cherukuri Narasimham and Subhadra Devi oration (March) and the
Srinivasa neurosurgery endowment oration (October). The department
holds a CME (How I do it video presentations) every year focusing on
a specific subspecialty and related cadaveric demonstration.
Other academic
activities
The concept of a local neurosciences club was
thought and was materialized as Tirupati Neuro club where the local
neurosurgeons, neurologists meet and share their experiences. In
view of the demand from our outgoing residents who wanted some
surgical videos depicting the critical steps of a surgery, we
started an online video library on YouTube (Neurosurgery@SVIMS
https://www.youtube.com/user/SVIMSneurosurgery/videos?view_as =
subscriber). This was very well appreciated by the younger
neurosurgical community.
Relationship with the
administration and other departments
The department shares a very cordial relationship
with the supporting departments especially the department of
neurology. The department of neurology was started and is headed by
Dr B Vengamma, an alumnus of SVMC Tirupati and NIMHANS Bangalore.
The coordination between the departments of neurosurgery and
neurology is one of the best among the neurosciences centers in the
country and is exemplified by the good results obtained in the
management of stroke and movement disorders.
The administration has always been supportive of
the department. Dr G Subramanyam, the former Director a implemented
the Arogyasri and Pranadanam schemes thus paving the way to an
increased patient load. Dr B Vengamma, the former Director procured
the latest equipment for the department and enhanced the surgical
armamentarium to be at par with any well developed neurosurgical
center in the country. Dr TS Ravikumar, the present Director started
the DBS program for movement disorders, streamlined the
emergency/trauma care, and introduced the concept of quality control
in health care.
Unique Traditions
Dr BCM Prasad introduced a lot of unique
traditions in the department to increase bonding among the faculty
and residents. All birthdays, teacher's day, any month with the
number of surgeries crossing a hundred, anybody returning from
hometown after a vacation warranted celebrations/treat. Every day,
we have a common lunch at the hospital. Get-togethers and Tirumala
temple darshans are planned regularly. The get-togethers include all
the faculty, residents, and supporting staff
