This doctor revolutionised laparoscopic surgery for thousands of women

A gynaecologist, a pioneer in laparoscopic surgery and a Padma Shri awardee, Dr. Manjula Anagani learnt early in life that knowledge is power. The second child of four children, Dr. Manjula calls herself a born rebel. She says that she was always good in academics and other extra-curricular activities.

“I was a tomboy,” says Manjula, “always competing with boys, fighting to play, climbing trees and most of the times playing outdoor games.” Her tryst with medicine happened due to her inquisitive mind. She says that as a child she always wondered how we process thoughts, how do we speak and other such questions. She says she knew the answers to her questions lay in the field of Medicine.

“When I would read about Nobel Prize winners in medical field and science, I too would be interested in trying to innovate newer things which would be useful. I knew then that I would be doing medicine,” says Manjula.

After getting the 58th rank in EAMCET, Manjula joined Gandhi Medical College. During this time, she realised she was interested in anatomy, and she knew she would be a surgeon. However, by the time she finished her internship, Manjula was increasingly drawn towards gynaecology. “I felt it was important to be a gynaecologist with a good practice rather than being a lady surgeon with less work to do or depend on others for referrals”.

Manjula adds that she has had fantastic teachers throughout her educational journey, who gave her a strong and solid foundation. Manjula started her private practice immediately stressing more on high risk pregnancies and management. It was during this time that Manjula began to focus on improvising surgical techniques, which would improve the outcome. She also began to look at ways of avoiding unnecessary Hysterectomies.

“Minimally invasive surgery was in its infancy when I started and it was a man’s world. All the techniques used were suitable for a malesurgeon.The immediate need was to innovate newer techniques, which were ergonomically suitable for women,” says Manjula.

However, hospitals at that point in time were not ready to invest in the advanced technology. While her peers were investing in material asserts, Manjula invested in medical technology and improving techniques investing in expensive equipment.

“It was difficult for many to comprehend that Gyn and Obstetrics was much more beyond deliveries and Hysterectomies. It took a lot of persistence, patience and perseverance to prove that minimally invasive surgery for woman is here to stay,” says Manjula.

Today, she adds that things have changed for good. She says that for limited morbidity and mortality minimal invasive surgery was the need. Manjula adds that mastering that art was her biggest challenge.

Renowned for her work in Laparoscopy and after having done over 10,000 laparoscopic surgeries, Manjula believes that a lot more can be done. Initially, the most dangerous and blind procedure in Laparoscopy was the Primary Entry port through which the surgery is done which needed a lot of force.

“We innovated a modified open entry technique, which was the easiest andsafest technique with no force, hence ergonomically the best for the operating surgeon. We also started the ipsilateral secondary port techniques – for the lady surgeons,” says Manjula.

According to Manjula, there are two important rules of laparoscopy – Safety of the patient and Comfort of the Surgeon. She adds that her work focused on that. She says they used preventive aspects in the surgeries like using adhesion preventive techniques – so as to prevent further complications and worked a lot in spreading it.

Speaking of the gender bias she has faced, Manjula says: “A woman will definitely have to work more than a man to prove herself in any field – but I also believe that one’s attitude is what determines our Altitude in Life. I think my attitude help me the most in overcoming any bias.”

She adds that spreading new ideas is always a challenge as people are resistant to change. She adds that one of the most difficult situations is the fact of feeling helpless. “We feel helpless in a critical situation of a patient, we have done everything we could – but still we are losing a patient,” says Manjula.

Also responsible for setting up Suyosha and Pratysha Support, Manjula says she set up these organisations along with Samantha and Sashi Manda. The organisations were established to bring in awareness of health in women, preventive gynaecological health and a little extra financial support for the neonates to decrease the morbidity and mortality.

Unfortunately, women in India according to Manjula do not give their bodies and health a high priority. “They themselves give the least priority to their health keeping their Families health first. They need to understand that they are the mainstay of the family system and if they are not healthy –the system is not healthy. They come to us after the so called remedies fail & as a last resort,” says Manjula.

Most of the gynaecological disorders can be prevented or controlled by a little bit of awareness. She says:

• Most common reason of kidney failure in women is recurrent urinary infections and they can be prevented by –taking adequate liquids, not holding and passing urine forcefully. It’s important to void urine before and after a sexual act
• Taking Vaccines as advised –HPV Vaccine to prevent cervical cancers and warts.
• Using a proper low dose contraceptives to avoid unwanted pregnancies and abortions
• Barrier Contraception to avoid sexually transmitted diseases
• Regular Gynaecological checkups–Papsmear. Mammograms, TSH, Ultrasounds, Bone mineral density as advised – to pick up any early health issues and managing accordingly to prevent further progress to any cancers and fractures.
• Only a diamond can cut a diamond –Only a Hormone can correct a hormonal imbalance- So, put aside the fear of Hormones and use them as advised by the doctor , under their supervision to avoid further complications
• Be a less Google doctor as Google cannot place you in the spectrum of the disease

Speaking of her inspirations, Manjula adds that her parents, teachers and even her patients have inspired her to progress in her field. She adds three things have been truly memorable in her life: when she decided against all odds to have her child, shifting her base to care hospitals to concentrate on minimally invasive surgery and high risk obstetrics and teaching.

“I was very lucky to be married into a family which always supported me in every decision I made. My husband– Kolli Suresh and daughter Srujitha– who is in her 11^th have always adjusted according to my schedule. I could not have asked for more,” says Manjula.