For the first time after months of excruciating pain in the tummy, Mr Frank Kasaija, a 45-year-old farmer from Ntoroko District said he felt relieved.
Kasaija, a patient who had an abscess in his liver, is one of the seven patients who benefited from the interventional radiology, an advanced image-guided medical procedure that Mulago National Referral Hospital has started conducting this week.
Dr Eva Nabawanuka, the interventional radiologist at the Mulago hospital, said they use normal imaging techniques such as ultrasound and CT scan to guide procedures for treating cancer, kidney problems, and other damaged organs and removing abscesses in delicate parts of the body.
“So, (through the imaging techniques) we are able to see something inside the patient and we are able to go ahead and do something about it. One of the patients that we have today (Kasaija) is a patient who has a mass in the liver. It is a liver abscess,” she told journalists before kicking off the life-saving procedure.
Previously, the radiologists at the facility would have just done the ultrasound or the CT scan, see what the problem is, and then sent Mr Kasaija to the theatre for the surgeons to cut and take this pus, which is in delicate part, out. The patient would then have to spend time at the hospital or away from work as the wound heals.
“But with interventional radiology, we are able to still use our imaging to do the procedure of draining this pus out within minutes. So my patient is not sleeping, he is not sedated. He is not going to the theatre,” she said.
While at the radiology unit, the team of interventional radiologists (doctors), radiographers, and nurses carried out varied roles to save Kasaija. He was laid on the Computed Tomography (CT) table where scans were done to determine the position of the abscess. On the same table, the doctors were able to remove the abscess in minutes.
“We are able to do all that through a very small prick using a needle. We don’t have to cut the patient. We put the needle inside the patient. We guide a wire through the needle,” Dr Nabawanuka said.
She added: “Once we have the wire inside the mass that we want to drain. We’re able to put the catheter and we are able to collect all the pus from the patient just using this small catheter. And that’s all we need.”
Dr Crescent Max Tumusiime, a consultant radiologist at the hospital, said: “It [the procedure] is usually done in 10 to 15 minutes, but today it took longer because we had guests.”
The entire procedure, including scanning and preparing the patient, lasted around 40 minutes.
“He (Kasaija) is going to walk away today and continue doing his work. He just needs to rest for around one hour. The advantage of this procedure is that it does not use a knife, but just a needle,” Dr Tumusiime said.
“We will keep monitoring him, but he returns after like two days [for review],” he added.
Testimony
Speaking to a journalist some 10 minutes after the procedure, Mr Kasaija said: “I feel better. I got an injury when I was looking after cattle early this year. I fell and I started feeling pain in my stomach. I went to different facilities for care but my problem continued.”
“I also went to Fort Portal Regional Referral Hospital, but it didn’t help. My sisters connected me to Mulago Hospital and it is from here that I got the surgery,” Kasaija added.
Mr David Nuwamanya, the hospital administrator, said they worked on Kasaija for free.
Dr Rosemary Byanyima, the acting director of Mulago Hospital, said they intend to make the new technique availed in other referral hospitals.
“We are happy that we have partners that we scale up this [operations together]. The hospital is ready to advance in the technologies we use,” she said.
Cost-saving
Dr. Eva Nabawanuka, the interventional radiologist at the Mulago Hospital, said patients are asked to make some payment to support the continuity of services at the facility, but a waiver policy is in place to help those with little or no money.
“Interventional radiology is actually cheaper for our patients in the long run. This is because we are able to do the procedure immediately in one sitting. The patient doesn’t have to go back and wait for the theatre. We don’t plan for theatre. There is no anaesthesia,” she said.
The expert said the procedure would reduce the number of people flying out of the country for such specialized services.
She said Uganda is one of the six African countries providing the service.
“We’ve been able to see at least 23 patients every day in the clinic,” she said.
