Ashok Raj Koul

Ashok Raj Koul (01-09-1962 to 20-03-2017)

Dr. Ashok Raj Koul was working as Chief of Department of Plastic Surgery at Sparsh Hospital (Narayana Health City, Bangalore). His microsurgery skills were par excellent and was a pioneering super-microsurgeon of the country. He was a very innovative surgeon and a great teacher.

Born in Shopian district of Jammu and Kashmir, Dr. Ashok completed his graduation from Government Medical College, Srinagar, in 1986. He completed his MS (General Surgery) at PGIMER Chandigarh in 1992. He was further selected for MCh in the Department of Plastic Surgery at PGI Chandigarh, one of the reputed Plastic Surgery centres of the country. Having completed his MCh in 1995, he joined a Fellowship in Hand and Microsurgery at Nizam's Institute of Medical Sciences, Hyderabad, in the year 1996 under Prof. Mukunda Reddy, whom he regarded as his guru. Here, he developed a keen interest in microsurgery.

In 1996, he joined Medical Trust Hospital at Cochin as a Consultant Plastic Surgeon. This is one of the oldest super-speciality hospitals in South India and Dr. Ashok headed the Department of Plastic, Cosmetic, Microvascular and Hand surgery until 2007. He soon established his reputation and his department at Medical Trust soon became one of the prominent centres for Microsurgery in South India. His successful bilateral upper limb replant for a 7-year-old girl gave him celebrity status among the public and received wide media coverage, which he rightly deserved.

He was a postgraduate teacher and had started the DNB course in 2002 in Kochi. Medical Trust Hospital was the first centre in India to start ‘Direct 5-year DNB course’ in Plastic Surgery under him. He played a significant role in starting and later conducting the quarterly CME programme by Kerala Plastic Surgeon's Association covering the whole syllabus of Plastic Surgery during the tenure of 3-year MCh course along with Dr.U.R. Nandakumar and Dr.Subramanian Iyer. It was the country's first such initiative and was later on followed in Tamil Nadu and then adopted by the Association of Plastic surgeons of India (APSI). His video series on ‘Common free flaps’ was the source of inspiration for many plastic surgeons, beginners and established ones alike and is still followed.

In 2007, he moved to Sparsh Hospital in Bangalore, where along with the DNB course, he started a popular Fellowship Programme in Hand and Microvascular surgery from which many students benefitted.

Dr. Ashok was a great teacher and used to ensure that his students grew in all aspects. He believed in the adage ‘See one, Do one and Teach one’ and gave his students supervised independence and insisted that they teach juniors. From the choice of flaps to post-operative positioning, everything used to be discussed in meticulous planning sessions. He would encourage students to suggest ideas and views, accepting and rejecting as deserved, always providing an explanation.

He was a regular faculty at Rapid Free Flap Harvest courses. He popularised ‘End to Side’ anastomosis for the free tissue transfers in lower limb and demonstrated his technique in multiple meetings. He was a visiting professor for the Ethicon microsurgery training courses. His presentations and teaching videos always carried a clear message and it always used to be a pleasure to watch his videos or him present them on the podium.

When the functional muscle transfer was in its infancy, he was amongst the first few surgeons to not only perform the surgery, but also popularise it in various conferences by talking about it, presenting operative videos and performing live surgeries. Not surprisingly, he was one of the founding members of the ‘Brachial Plexus Study Group’ and ‘Indian Society of Peripheral Nerve Surgery’ and attracted many youngsters to it. He was daring and would salvage limbs using outrageously ambitious microsurgery. Similar was his initiative for breast reconstruction and actively promoted post-mastectomy breast reconstruction. He was active member of breast reconstructive and aesthetic surgery group. When Phillip Blondeel published his work on ‘Perforator Flaps’, he came up with his own simplification ‘The Freestyle Free Flap’: Perforator flaps from unnamed perforators harvested as free flaps and used to cover defects by supermicrosurgery. He received the ‘Best Paper’ prize for the presentation, ‘The Freestyle Free Flap’ at the international perforator course in Coimbatore 2008.

Dr. Ashok was a skilful surgeon and a born innovator. He always thought out of the box and yet in a very scientific way. He popularised his own method of weakening the helical cartilage to correct prominent ears. The haloframe application for scalp replants to avoid pressure over the replanted scalp was another such innovation. His way of post-operative splinting the free tissue transfers and replantations in upper limbs with external fixator was another example. He described ‘Boomerang-shaped Extended Rectus Abdominis Myocutaneous Flap,’ (BERAM Flap) which is arguably the longest flap available in the body, and recently, he had extended it further to cover a defect from the upper thigh to the ankle (yet to be published). He was eager to innovate and give patient the best and was the first to successfully attempt a Simo-Vilkki procedure of vascularised great toe MTP joint transfer to the radiocarpal joint in India.

Dr. Koul was a member of the Advisory Board of Indian Journal of Plastic Surgery and a very useful reviewer of the journal. His reviews would invariably add value to the manuscript for its eventual publication. In his untimely demise, the journal has lost a just reviewer and the ‘APSI’ has lost an invaluable teacher and an inspiring leader.

He had contributed several chapters to textbooks and had several publications in national and international journals. He won the Kamath Prize for the best poster at APSICON 2000 in Agra. His passion for complex reconstructions, brachial plexus and microsurgery was unmatchable.

He truly lived up to new-age ideals, achieving the perfect ‘work-life balance,’ being an actively involved and loving father and life partner. He is survived by his wife Dr. Asha Koul, an anaesthetist and 2 daughters. Parul, undergraduate student at Wellesley College, USA, and Aditi just completed high school. His untimely demise has left all in grief and the void created cannot be filled. Please visit: www.drashokkoul.in.