‘The benefits offered by Spy-Glass are unparalleled and compensate for the additional costs incurred’

Deenanath Mangeshkar Hospital and Research Center, Pune recently installed a SpyGlass system. Dr Amol Bapaye, Chief, Department of Digestive Diseases & Endoscopy, Deenanath Mangeshkar Hospital & Research Center, Pune, India gives more information about the technology and the benefits it offers to doctors as well as patients, in an interaction with Lakshmipriya Nair

Why did you decide to install the SpyGlass system?

Our hospital is a high volume centre for ERCP procedures – a technique used to diagnose and treat conditions of the biliary and pancreatic ducts. We often encounter situations wherein ERCP and additional tests like CT scan, MRI and/or endoscopic ultrasonography (EUS) fail to diagnose the exact pathology, because of which treatment is often compromised.

Elaborate on the benefits offered by the Spyglass system vis-a-vis other, generally used equipment.

With the addition of Spy-Glass cholangioscopy, the diagnostic accuracy for these conditions – especially cancers of the bile and pancreatic ducts has improved dramatically (from 70-75 per cent using a combination of earlier technologies vs > 90 per cent after use of Spy-Glass).

Another major use of Spy-Glass is for treatment of stones in the bile ducts. Large bile duct stones need fragmentation (lithotripsy) prior to their removal. Although certain lithotripsy techniques can be performed during standard ERCP, these techniques have limited efficacy and therefore may not guarantee results.

Patients often therefore needed multiple sessions of ERCP for removal of these large stones, and one could not guarantee safe removal. Using Spy-Glass and Holmium laser lithotripsy, fragmentation of these large stones is easy and efficient. The procedure can almost always be completed in a single session, and multiple sessions are rarely necessary. Stone fragmentation and removal are guaranteed and failures are rare.

How much have you invested into the technology?

The Spy-glass system costs approximately Rs 40 lakhs and has certain consumable items that cost approximately Rs two lakhs.

How cost-effective is the system? Would it add to the cost of endoscopic procedures for the patient?

Although the cost of the procedure using Spy-Glass is higher than routine ERCP, the benefits offered by Spy-Glass are unparalleled and more than compensate for the additional costs incurred. Alternative methods for treating large bile duct stones may involve invasive major surgery with resultant additional hospital stay, costs and risks of complications. Failure of accurate diagnosis – especially for bile duct or pancreatic duct cancer, can have severe consequences with a resultant risk to life or quality of life.

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