In the year 1951, there was a conference of renowned Gynecologists and Obstetricians from all over the world at Paris. The representative from India thundered in the Conference that no woman should loose her precious baby because of cervical incompetence. He disclosed a totally different and innovative approach for cervical incompetence. He described cervical cerclage operation for habitual second trimester abortion. The same operation he described at Naples in 1956. Gynecologists and Obstetricians all over the world accepted his technique and the operation was aptly christened as “Shirodkar Cerclage”. This innovative, different, dynamic personality was no other than Dr. Vithal Nagesh Shiordkar.
Dr. V. N. Shirodkar was born on 27th April 1899 in Shiroda, Goa. After his graduation in medicine from Grant Medical College, Mumbai, India, he went to United Kingdom. In 1931, he obtained his fellowship from the Royal College of Surgeons (FRCS). Here he got opportunities to interact and associate with Prof. J. Chassar Moir, Victor Lack, J.D. Murdock and others.
He returned to India in 1935 and immediately joined Sir J.J. Group of Hospitals as an Hon. Obstetrician & Gynecologist. He tutored under Dr Samson Wright and conducted experimental work in preeclampsia showing angiospasm in 1938.
Dr. Shiordkar had keen sense of questioning everything that was routine. Shortfall, failure of any technique, operation motivated him to improve & modify them. For this he went into the basics. He carefully studied the anatomy and physiology of genital system. He was particularly interested in the changing nature of cervix during normal pregnancy from fibrous to a dynamic muscular organ. Thus an answer to the habitual second trimester operation was born. Cervical cerclage operation was performed on cervix for the second trimester habitual abortion and with his engineering skill he developed instruments to perform the same. There have been many modifications, most notably from Dr. McDonald but the original surgery is the masterpiece. Thus, Dr V N Shirodkar and his studies on the cervix put India firmly on the map of operative obstetrics and gynecology.
Dr. Shirodkar wrote in the preface to his monograph, “With all due respect to the masters, I did not reconcile myself to some of the operative procedures which fell far short of the ideal, ideas came to my mind for improving the time honoured methods”.
He was a great teacher & innovator. Students loved and enjoyed his lectures.
Amongst his many surgical contributions, one counts the operations for prolapse repair, tuboplasty and creation of a neovagina. He had an engineering brain thus modified and came up with new procedures for many gynaecological contribution such as operations for prolapse, vaginal and abdominal approaches conserving the cervix which he emphasized that was necessary for further pregnancies due to cervical factor and its competence. He kept on improving his surgical procedures and techniques. The classic example is of Cervical Circlage. At the Silver Jubilee Celebration of the French Society of Gynaecology in June 1951, Professor Shirodkar showed a film demonstrating an operation to place a ligature comprising three strands of catgut around the cervix for Cervical circlage. He soon found that catgut was not appropriate for suturing because of its solubility. He modified his technique by using a strip of fascia lata from the thigh and linen sutures for the cervical cerclage operation.
In 1960, he published contributions to Obstetrics and Gynaecology based on his personal experience. He contributed a chapter on Incompetence Cervix in Volumes IV & V of Progress in Gynaecology by Meigs and Sturgis in 1963 & 1970. In 1967, his views in genital prolapse was incorporated in the chapter entitled “A New Approach to the Understanding of the Anatomy & Treatment of Uterine Prolapse” in Advances in Obstetrics and Gynaecology which was edited by Marcus & Marcus. He also wrote about his techniques of placing a vaginal hood over the cervix as a method of contraception.
Dr. V.N. Shiordkar had very busy practice in spite of this, he took keen interest in social medicine. He was a member of the Shantilal Shah Committee on abortions. He established the Family Planning Association in India. In 1960 and in 1971, very deservedly the Government of India honored him with Padma Bhushan, and Padma Vibhushan awards, respectively.
He was an accomplished violinist and had keen interest in painting and sports (Fig. 1).
Fig. 1.
Painting of Haji Ali by Dr. V. N. Shirodkar
Such a great man, thinker, innovator, teacher, surgeon par excellence, thus multifaceted human being passed away on March 7, 1971 in Mumbai. We all salute him as a pioneer in experimental surgery and gynecology.