Doctor Gyan Chand: a leading figure of bilateral axillo-breast approach (BABA) in endoscopic thyroidectomy in India

The 2017 Annual Congress of International Society of Oncoplastic Endocrine Surgeons (ISOPES) in conjunction with 3rd International Thyroid Oncological Conference of Zhejiang Province was held in Hangzhou, China from April 20 to 23. Dr. Gyan Chand was invited as guest faculty to this conference and gave us a wonderful speech on “Endoscopic Thyroidectomy through BABA: Initial Experience from Developing Country”. We were honored to have an interview with Dr. Chand to share with our readers his experiences and the current application of BABA in endoscopic thyroidectomy in India.

Dr. Chand (Figure 1) did his surgical training from King Georg’s Medical College, Lucknow, India and after that he further studied Endocrine Surgery from Sanjay Gandhi Post Graduate Institute of Medical Sciences in the same city. He then trained in breast surgery from Nagoya University, Nagoya, Japan and thyroid cancer surgery from Memorial Sloan Kettering Cancer Center (MSKCC), New York, USA. He had work experience as the faculty of medicine in BRD Medical College, Gorakhpur and GSVM Medical College in Kanpur. Presently, he is working as an Additional Professor in Endocrine & Breast Surgery at SGPGIMS in Lucknow, where he is performing all types of endocrine & breast surgeries. His special area of interest is minimally invasive endocrine surgery and molecular pathogenesis of thyroid cancer. He has also kept pace with the latest surgical procedures and published a review article about the advanced techniques in today’s medical practice. In 2011, he obtained a position in the International Cancer Technology Transfer Fellowship (ICRETT) and in 2015 he obtained international fellowship in robotic thyroid surgery from Seoul National University, Seoul, South Korea.

Figure 1 Doctor Gyan Chand.

I was deeply impressed by Dr. Chand’s attentiveness when I first saw him during the break of the conference. He was at a booth, engaged in discussion over some advanced techniques with the representative. He told us about his great interest in sophisticated techniques and the latest surgical procedures during the interview. “India is an iodine deficient region, where large goiters are commonly found in young women”, he said, “However with the backward economy, lack of educations and awareness about the thyroid disorders among the rural populations, there are still many patients who have not received any treatment”. Therefore Dr. Chand is keen to import some more advanced foreign equipment and technologies to help his people.

Before Dr. Chand elaborated on the topic of bilateral axillo-breast approach (BABA) in endoscopic thyroid surgery he introduced a variety of existing approaches applied in contemporary thyroid surgeries, including minimally invasive video assisted approach, endoscopic approach, robotic approach and natural orifice thyroid surgery. Among these different approaches, the breast and axillary approach is the easiest to perform and the most ideal for the Indian patients as they usually present with large goiter. BABA is a modification of ABBA (axillo-bilateral-breast approach). It consists of incision in the areola as well as the axilla. The bilateral access can enhance the visualization of the thyroid gland. He also described some specific process when applying this method, such as the skin markings and port placement. According to Dr. Chand, endoscopic thyroidectomy via BABA is a safe and effective method as it is characterized with good surgical completeness, low rate of postoperative complications, low recurrences, excellent cosmetic result, as well as affordable treatment cost for patients. He would like to make more progress on this approach to benefit the patients.

Dr. Chand was excited to tell us his latest project, of “Surgical Outcome and the Quality of Life after Endoscopic Thyroid Surgery through Bilateral Axillary and Breast Approach (BABA)”. He said that the quality of life of patients with benign thyroid diseases is an important therapeutic goal for him. He believed that improving these patients’ quality of life is not only meaningful to patients themselves, but also can lighten the burden of their family and the society. “I want to try my best to do something for my patients”, Dr. Chand said, “The happiness of patients is what I am pursuing”.

Acknowledgments

On behalf of the editorial office of Annals of Thyroid (AOT), I would like to extend my gratitude to Dr. Chand for sharing his opinions with us.

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Annals of Thyroid for the series “Meet the Professor”. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/aot.2017.08.02). The series “Meet the Professor” was commissioned by the editorial office without any funding or sponsorship. The authors report that they are full-time employees of AME Publishing Company. The authors have no other conflicts of interest to declare.

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(Science Editors: Monica L. Liu, Yating Kong, AOT, aot@amegroups.com)