Texas Tech Physicians of El Paso’s Department of Surgery hosted sixteen surgeons from three different institutions in mid-February, at Texas Tech University Health Sciences Center El Paso for training on an innovative minimally invasive surgery procedure to remove gallstones from the bile duct.
The gallbladder is a small organ under the liver that assists with the digestive process by storing bile, a fluid that helps break down fats in the intestine. Sometimes the chemicals in bile harden into stones, small deposits that can block bile ducts. The blockage in the gallbladder or bile duct is a sign of biliary disease, and can result in intense abdominal pain and require surgery.
The surgeons trained for laparoscopic trans-cystic common bile duct exploration (LCBDE), a minimally invasive procedure that uses a long thin scope (camera) inserted through a small incision in the abdomen. Surgeons guide the scope through the bile ducts to locate gallstones. The scope is called the SpyGlass Discover (Trademark Boston Scientific). Once a stone is visualized, a retrieval basket allows surgeons to capture and remove gallstones.
Alonso Andrade, M.D., FACS, a general surgeon at Texas Tech Physicians of El Paso and a TTUHSC El Paso assistant professor of surgery, said the innovative SpyGlass Discover scope allows surgeons to remove gallstones from the bile ducts during the same procedure to remove the gallbladder. This approach spares the patient from having to endure a second procedure to remove the gallstones.
“Stone retrieval usually requires an additional procedure by a gastroenterologist via scopes passed through the mouth,” said Dr. Andrade, who also serves as the associate residency program director for the Department of Surgery. “That means patients have to stay in the hospital longer or come back for the second procedure. Thanks to the technology by Boston Scientific, we can remove the stones through the same incisions we’ve made for the cholecystectomy.”
A single minimally invasive procedure allows patients to go home on the same day, which is a major benefit for both patients and hospitals during the COVID-19 pandemic.
Both Dr. Andrade and Brian Davis, M.D., FACS, FASGE, a general surgeon at TTP El Paso, a Department of Surgery professor and residency program director at TTUSHC El Paso, have been doing the gallstone surgery procedure for about two years. They were instrumental in bringing the training event to El Paso with the help of Boston Scientific.
Seven surgeons from TTUHSC El Paso and TTP El Paso along with nine from William Beaumont Army Medical Center attended the training. Residents also attended and will continue to train on the procedure. This simultaneous training event was the largest single educational event for this LCBDE procedure in the country to this date, according to Giovanni Sani, Boston Scientific’s territory manager.
TTUHSC El Paso serves as the LCBDE training hub for the region which is a benefit to the El Paso area because biliary disease is the largest population health problem for surgeons in the region, according to Dr. Davis, due to long hospital stays and misperceptions of complication rates.
“This continues the mission of the Foster School of Medicine, which is to advance medical care, be involved in research and be at the forefront of new techniques,” Dr. Andrade said. “We can teach it to our residents, use it on our patients and improve the quality of care for the community.”
Grace Ng, M.D., a trauma and critical care surgeon at TTP El Paso; assistant professor, assistant trauma director and pediatric trauma director for the Department of Surgery at TTUHSC El Paso; was one of the trainees in attendance on Thursday.
“Gallbladder disease and gallstone disease is rampant in El Paso, and gallbladder surgery is one of the most common things we do here,” Dr. Ng said. “Being able to do this is a major benefit for the patients.”
TTP El Paso is the region’s largest multispecialty medical group practice, with over 250 specialists and subspecialists providing care for the entire family at several locations across El Paso. It is also the clinical practice of the Foster School of Medicine, as the physicians who comprise TTP El Paso each hold faculty appointments at the medical school, where they teach the next generation of doctors.