Dr Saurabh Mukewar
Principal Correspondent :
An old man with his frail condition suffering from advanced cancer, not fit for surgery got a new lease of life when Dr Saurabh Mukewar, a young Gastroenterologist, an expert at interventional Endoscopy performed an unique procedure. Interventional Endosonography (EUS) is an emerging field offering minimally invasive treatment options for various gastrointestinal conditions. Recently at Midas, a patient with an inflamed gallbladder (acute cholecystitis) was treated with a novel ‘painless’ procedure called ‘cholecysto-gastrostomy’ (connection between stomach and gallbladder) performed for the first time in Central India using the new ‘Hot Axios’ metal stent.
Patient is an elderly man with advanced stage cancer of bile ducts with blockage and jaundice, for which he underwent placement of metal stents at Midas successfully earlier. He presented 5 months later, severely ill due to an inflamed gallbladder with a small liver abscess (pus pockets in liver). “Such patient would typically undergo surgery for removal of the gallbladder but given his frail condition and advanced cancer he was not felt to be a good surgical candidate. The other option is a plastic tube placed across the skin in gallbladder (Percutaneous Cholecystostomy), which can be painful and he would also have to carry a plastic bag externally over his skin for the remainder of his life,” said Dr Saurabh Mukewar. Dr Saurabh Mukewar performed this procedure with Dr Tejas Sadavarte, Dr Mugdha Mule and the endoscopy team - Shailesh Chauhare, Chandrashekhar Barai and Rahul Bhapkar.
The novel metal stent was placed across the stomach into the gallbladder with endosonography guidance, allowing the pus and contents to empty inside the stomach. The patient had no pain, prompt recovery with significant improvement in his symptoms and was discharged 2 days later. Dr Mukewar trained in advanced endoscopic procedures at UCLA (USA) and worked as an advanced endoscopist at Weill Cornell Medical College/New York Presbyterian Hospital before returning to India. He is currently a consultant gastroenterologist at Midas andhas performed over 1,000 EUS procedures, including more than 50 ‘Hot Axios’ placements in USA. Instead of staying in USA, he came to Nagpur with his advanced endoscopy skills and new approaches to take care of patients of the country.