February 27th, 2017
A Bradford consultant has been using his expertise to introduce a new medical procedure to Sri Lanka’s hospitals for the benefit of patients.
Dr Harry Bardgett, a consultant radiologist at Bradford Royal Infirmary, learned of the plight of people suffering from kidney stones on the island during a chance meeting with Eastbourne-based consultant urologist, Graham Watson, who runs his own charity.
The Medi Tech Trust is dedicated to the promotion of urological surgery and donation of medical equipment and surgical goods in the UK and the developing world.
Last June, it kindly donated new equipment to BRI called ‘Ultra Mini PCNL’ (percutaneous nephrolithotomy) , which brings huge benefits as doctors can use much smaller equipment than that traditionally used to carry out kidney stone surgery in the past.
It was during this visit that Mr Watson witnessed Dr Bardgett using ultrasound to guide surgeon’s access to the kidney for percutaneous nephrolithotomy (PCNL).
This innovative technique enables his fellow doctors to glean better pictures of the kidneys, allowing them to shatter and extract stones using an endoscope, instead of the need to revert to open surgery with its risks to the patient.
Removes stones from the kidney
PCNL is a minimally-invasive procedure which removes stones from the kidney by making a small incision (up to about 1cm) in the skin. It is ideally used to remove stones of more than 2cm in size which are present near the pelvic region.
Impressed by what he saw, Mr Watson asked Dr Bardgett to accompany him to Sri Lanka to show doctors there this new technique, which is less damaging to patients and helps them recover more quickly.
Dr Bardgett explained: “PCNL ultrasound has huge benefits for surgeons as it helps identify which part of the kidney to puncture into. Doctors can then can see the renal stones and glean important information on the structures around the kidney.
“It also makes the procedure easier to perform as with PCNL the patient lies on their back rather than their front.
“Other vital PCNL benefits for patients include reduced blood loss, less damage to the kidney and a shorter hospital stay. For some, the stay can be as little as 24 hours, as opposed to around four to five days previously.”
Dr Bardgett and Mr Watson visited Sri Lanka with consultant urologist Zubeir Ali, from the Royal London Hospital, last month.
Island’s next generation of doctors
During the 10-day trip, Dr Bardgett also helped train the island’s next generation of doctors, as well as UK surgical trainees who accompanied him on the visit to gain extra operating experience under supervision.
Dr Bardgett added: “The Medi Tech Trust’s aim is to teach Sri Lankan and UK surgeons modern stone procedures by using endoscopes (tiny cameras which help doctors to see inside the kidney) as opposed to carrying out open surgery.
“By using endoscopes, surgeons can see the stones, break them up and remove them in fragments.
“When Graham first visited the island he found such a huge patient workload that he decided to take surgeons, who were completing their training in the UK, to Sri Lanka with him to give highly concentrated training sessions.”
These intensive, hands-on training courses are now part of the charity’s ‘Stonebuster Initiative’ which encourages non-invasive, surgical procedures and modern stone surgery.
Dr Bardgett continued: “We visited two hospitals - Colombo South Teaching Hospital and Kandy General Hospital - teaching Sri Lankan and UK trainees PCNL access, as well as supporting established Sri Lankan consultants to consider a move to this new approach (supine under ultrasound scan) which helps identify and shatter kidney stones.
Moved away from traditional open stone surgery
“Thanks to Mr Watson’s efforts and work with local urologist Professor Srinath Chandrasekera, Sri Lanka has moved away from the more traditional open stone surgery which had higher morbidity rates, left the kidneys with scaring and was less likely to make the patient stone free.
“It was incredibly rewarding work to know that you are making a difference to a patient’s life and if I am asked to return, I will.”
During their recent trip, the team also donated modern equipment to the hospitals and helped reduce the island’s kidney stone waiting list by carrying out 21 procedures.
The link between the Medi Tech Trust and Bradford was forged by Dr Bardgett’s colleague, consultant urologist James Foster, who as a registrar, fundraised for the organisation and travelled to Sri Lanka to carry out kidney stone operations.