Inside the Operating Room.

By: Ayush Madan

Surgery intrigued me because of its immediacy and the tangible difference it makes in patients’ lives.

Dr. Avtar Singhsachthep is a seasoned general and colorectal surgeon with over four decades of experience, largely spent at Bumrungrad International Hospital. As one of the first Sikh doctors at an international hospital in Bangkok, his journey from Delhi University to becoming a cornerstone of Bumrungrad International Hospital’s surgical department is a testament to his dedication and hard work. When I met him, Dr. Avtar shared insights into his background, professional journey, and observations in the evolving field of surgery. His extensive experience, coupled with his ability to communicate across cultures, underscores the importance of a holistic approach to patient care. Personally, as someone who’s hoping to enter the medical field in some form or another in the future, I can honestly say that seeing Dr. Avtar’s commitment to providing top-notch medical services to patients from all walks of life is nothing short of aspirational.Tell us a little about your personal and professional background.

I was born and partly raised in India before attending boarding school at St. George’s College, Mussoorie. After graduating in 1971, I went on to study pre-med in Chandigarh for a year before receiving a full scholarship from the Indian government to attend what was then the University of Delhi (now Delhi University), where I studied at Maulana Azad Medical College. I graduated in 1977 and came to Bangkok for my internship, eventually taking the Thai medical exam and embarking on my surgical training.

What drove you to become a general surgeon?

Surgery intrigued me because of its immediacy and the tangible difference it makes in patients’ lives. The ability to directly solve a problem and see the results was a significant factor in my decision to pursue general surgery.

What was the process like getting licensed in Thailand with a degree from Delhi University?

Getting licensed in Thailand was straightforward for me, although I understand it has become more challenging over the years. The diseases and medical conditions in Thailand and India are quite similar, which helped. Learning Thai was crucial, and I took lessons from a retired Thai teacher to become proficient.

Many people in the Thai-Indian community and beyond see Bumrungrad International Hospital as the gold standard of medical care in Thailand. What sets it apart from the rest?

Bumrungrad International Hospital has grown from a small hospital to a large, internationally-recognised institution. Our teamwork, standardised procedures, and dedication to providing the right treatment without going off track are key factors. Over my 40-year journey here, the hospital has expanded from 100 beds to over 500, continually improving facilities and services.

New research shows that young adults are getting colon and rectal cancer at alarmingly high rates. As someone whose special clinical interests includes colon-rectal surgery, do you see a similar trend in the patients you see at Bumrungrad International Hospital?

Yes, I have observed a similar trend. Lifestyle and dietary changes, such as increased consumption of processed food and red meat, might contribute to this rise. However, we can’t pinpoint specific foods as direct causes without considering the context. The fact is, improved technology, better global health literacy, and increased use of colonoscopies allow us to detect these cancers at a more frequent rate, naturally leading to more diagnoses. The upside is that early detection gives the patient more treatment options and better chances for entering remission. What specific criteria need to be met before you refer a patient for colorectal surgery?

Initially, general surgery covered everything, but over time, specialities like colorectal and breast surgery branched out. Patients might come directly or be referred if their condition falls within the scope of colorectal surgery. With advancements in laparoscopic surgery, we now prefer minimally invasive techniques, but open surgery remains essential in many cases.

One of your special clinical interests is also Minimal Invasive (Laparoscopic) Abdominal Surgery. How has the field of laparoscopic surgery evolved since you began your practice?

Laparoscopic surgery has revolutionised the field with its minimal scarring and faster recovery times. The basic surgical principles remain the same; the difference lies in using smaller instruments. We adopted laparoscopic techniques early on, around 1988, soon after they were developed in Europe.

How does speaking multiple languages enhance your ability to provide patient care?

Speaking multiple languages is a significant advantage because communication is crucial in medical practice. You can learn all there is to learn about medical science, but treating a patient, steering them towards a treatment plan, making sure they understand the procedure and why it is necessary – this is all an art. At Bumrungrad International Hospital, we have interpreters for over 16 languages, but personal language skills can enhance this connection further. I speak English, Punjabi, Hindi, and Urdu. But truthfully, had I known I would see so many patients from Bangladesh, I would have learned Bangla too. [Laughs]

Can you describe a memorable case or patient that had a significant impact on you?

During my training in Chonburi, known as a ‘Cowboy Town,’ I frequently treated gunshot wounds, often opening abdomens every other night. These cases were challenging but provided immense satisfaction when we could save lives. Knowing that you made a difference in a critical situation, knowing that you intervened to keep them alive – those are the cases that stick with me.

You have been working with the Indian diaspora for a very long time in terms of health and your speciality. What are your key observations?

The Indian community here has been with us for a long time and feels confident consulting with Indian doctors. However, many are also comfortable with Thai doctors due to their fluency in Thai and familiarity with the local medical system. We see patients from all over the world, and referrals often come when cases are particularly complicated, highlighting our reputation for reliable, team-based care.