Why I chose Shalya Tantra over modern surgery alone

Why I Chose Shalya Tantra Over Modern Surgery Alone

By Dr. Vipin Tongale, MS Ayurveda Shalya Tantra, PhD

Introduction

When I tell people I am an MS in Ayurveda Shalya Tantra, they sometimes ask why I did not "just do MBBS and MS General Surgery." The question implies a hierarchy: modern surgery at the top, Ayurvedic surgery somewhere below. In this piece I want to explain why that hierarchy is misplaced, and why my choice was deliberate rather than compromised.

What Shalya Tantra Actually Is

Shalya Tantra is one of the eight classical branches of Ayurveda. Its foundational text is Sushruta Samhita, composed over two thousand years ago. Sushruta describes surgical instruments, procedures, anaesthesia, wound management, and post-operative care with remarkable systematic detail. He is often referred to as the father of surgery.

The modern MS Ayurveda Shalya Tantra programme is a three-year postgraduate degree that combines classical Ayurvedic surgical training with substantial exposure to modern surgical principles, anatomy, pharmacology, and clinical practice. Graduates practise as surgeons in general surgical conditions with particular expertise in anorectal work, Ksharsutra, Uttarbasti, and classical Ayurvedic surgical techniques.

Why I Chose This Path

I could give a philosophical answer about respecting tradition, but that would be incomplete.

The practical answer is this: as an anorectal specialist, my patients need both classical Ayurvedic tools (Ksharsutra, Ksharkarma, Uttarbasti, Panchakarma) and modern surgical tools (laser, minimally invasive techniques, modern wound management). A patient with a complex recurrent fistula may be best served by Ksharsutra. Another patient with simple Grade II piles may be best served by laser or a non-surgical procedure. A patient with a stricture urethra may benefit from Uttarbasti. A patient with an acute abscess needs immediate drainage.

Shalya Tantra training gave me competence in all of these. The alternative, training as an allopathic general surgeon, would have given me competence in modern techniques but no formal training in classical Ayurvedic ones. I would then either have to add Ayurvedic techniques informally, which is not the same as postgraduate training, or refer patients away for classical treatment.

The choice was not compromise. It was optimisation.

What This Means for Patients

If your case is best treated by a classical Ayurvedic technique, I can offer it competently. If your case is best treated by a modern technique, I can offer that too, or coordinate with expert visiting specialists for procedures beyond my direct scope (like laparoscopic cholecystectomy).

The important thing is that the recommendation to you is honest, based on what your case needs, not what my training happens to include.

This is why I have deliberately built a practice that offers Ksharsutra, laser, non-surgical, and conventional options, and why I recommend the one that fits your case rather than defaulting to whichever I have most invested in.

The Broader Point

There is a false framing in India that pits modern medicine against Ayurveda as if they are competitors. In practice, the frame is unhelpful for patients. What patients need is honest evaluation and appropriate treatment. Sometimes that is modern medicine. Sometimes that is Ayurveda. Sometimes that is both, coordinated.

Doctors trained only in one tradition often struggle with this because their instinct is to recommend within their scope. Doctors trained in both, or willing to work with both honestly, can serve patients better.

My choice of Shalya Tantra was, in this sense, a choice about the kind of doctor I wanted to be for my patients. I do not regret it.

What Has Not Changed

Fifteen years, sixteen thousand surgeries, one PhD, and a hospital later, my core belief is unchanged: the right treatment for the patient in front of you is the right treatment, regardless of whether the framework is classical or modern.

I would like to see Indian medicine move in the direction of that pragmatism. Fewer camps. Fewer identity politics between systems. More honest care.

Dr. Vipin Tongale is co-founder of Shri Manmukund Hospital, Amravati, and Assistant Professor of Shalya Tantra (formerly at Mahatma Gandhi Ayurved College, Salod, and Vidarbha Ayurved Mahavidyalaya, Amravati). He completed his MS in Ayurveda Shalya Tantra (2010) and PhD (2024) from Government Ayurved College, Nanded. His PhD research examined the safety and efficacy of Apamarga Kshara ointment in internal haemorrhoids management.

• Dr. Vipin's page
• Ksharsutra hub
• Understanding Ksharsutra in Simple Terms