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A New Frontier in Interventional Radiology

VA radiologists
Dr. Smith, radiologist, Dr. Vyas, radiologist, and Dr. Mohab Elmohr, resident radiologist, use new SpyGlass Discover imaging to diagnose and perform a therapeutic procedure for an ureteral obstruction on Sept. 30 at the Michael E. DeBakey VA Medical Center.

A new tiny camera is helping doctors at the Michael E. DeBakey VA Medical Center remove gallstones and relieve ureteral obstructions – all without the need for surgery.

In June, the Interventional Radiology section began using SpyGlass Discover, a digital catheter that provides direct visualization inside organs such as the gall bladder, bile ducts, and kidney, through a minimally invasive access.

The technology is a small flexible tube with a light and a video camera at the end. It can also be fitted with accessory devices for procedures.

“They've made these cameras so small that we can use them through tiny little accesses, whether it's through a bile duct or into a kidney, and actually see what things really look like,” said Dr. Rayhan Hai, chief, Interventional Radiology section “It’s a new frontier.”

The team has used the SpyGlass to perform gallstone retrievals and to relieve ureteral obstructions, blockages in one or both tubes (ureters) that carry urine from the kidneys to the bladder. 

Through a small needle stick on the side of a patient’s body, they can gain access to the gallbladder and directly see the gallstones. The radiologists can then remove the gallstones by breaking them up and sweeping them out through a bile duct or retrieving them with a catheter.

Without this technology, patients who cannot have surgery are dependent on a gallbladder drain for the rest of their lives.

“When a patient gets a cholecystostomy tube placed, if they can't go to surgery, they have to keep coming to us for frequent tube exchanges,” said Dr. Ajit Vyas, Houston VA radiologist. “But with the spyglass technology, we can potentially remove the tube all together.”

Similarly, relieving ureteral obstructions allows patients to regain their ability to urinate and not be dependent on a catheter.

“In Interventional Radiology, we always have this discussion about how we can improve patient care and quality of life,” said Dr. Darryl Smith, Houston VA radiologist. “Certainly, being able to remove a catheter is a definitely a big quality of life improvement. That's the number one thing for us - to help our patients.”

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