Hyderabad's AIG Hospital scripts history

In a first in Asia, city-based hospital uses disposable duodenoscope — a 100% sterile equipment which helps prevent hospital-acquired infections — to operate on a 93-year-old patient with bile stones
Dr D Nageshwar Reddy, AIG Hospitals
Dr D Nageshwar Reddy, AIG Hospitals

HYDERABAD:  The AIG Hospitals in Hyderabad has become the first hospital in Asia to use a disposable duodenoscope. The equipment was used to operate on a 93-yearold immunocompromised patient, who was suffering from bile infection caused by stones.

The infection had begun spreading into the patient’s blood, causing septicemia. The benefit of using the disposable duodenoscope over the multiple-use duodenoscope is that the doctors could create a 100 per cent sterile setup to perform the surgery.

This is essential, as the nonagenarian man stood a high risk of contracting hospital-acquired infections, due to his health condition and age. Dr D Nageshwar Reddy, Chairman and Chief of Gastroenterology, AIG Hospitals, said, “This is the start of a new era in therapeutic endoscopy where disposable duodenoscope can be used to cut the infection rate dramatically. As is known, hospital-acquired infection is very common and a leading cause of mortality worldwide.

There is 1-5 per cent chance of acquiring these infections, and it proves fatal in almost all cases. Multipleuse duedenoscopes are especially risky because they cannot be sterilised 100 per cent even with best practices. Disposable apparatus are a boon for vulnerable patients”. The disposable duodenoscope costs `2 lakh. While the multiple-use duodenoscope costs `50-60 lakh, it is used over 5,000 times across different cases, making it a less sterile alternative.

The AIG Hospitals is planning to use the disposable alternative routinely on patients needing a high degree of care, like cancer patients, senior citizens, immunocompromised patients, and those on steroids or chemotherapy. The disposable apparatus was used by Dr Reddy and a group of doctors in January last year in the USA. Since then, it has been launched in four countries, where it was used about 180 times so far. “A common misconception is that since it is disposable, it is of inferior quality. But that is not the case. The disposal duodenoscope is made of plastic and technologically advanced materials, which help cut costs,” added Dr Mohan Ramchandani, Director Therapeutic Endoscopy, AIG hospital.

Another first

The procedure involved another first — the disposable duodenoscope and another equipment, the spy cholangioscope, were used together in the surgery. Four stones were removed from the patient. “To remove one large stone stuck in the bile duct, we had to improvise on the go and use another disposable spy cholangioscope with laser lithotripsy. Using precise laser lithotripsy, the large stone was fragmented and extracted,” said Dr Ramchandani.

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