Picture an operation that is non-invasive, inexpensive and does not require the use of general anaesthesia.This is the reality citizens of T&T have taken far too long to realise, according to director of interventional radiology at Eric Williams Medical Sciences Complex (EWMSC) Dr Rodney Ramroop.He was speaking exclusively with the Sunday Guardian from his office where he lauded interventional radiology as "the surgery of the 21st Century."Ramroop, the only resident interventional radiologist in T&T since 2001, said many of his patients were always impressed by how efficient the procedure was and equally appalled by its lack of exposure to the general public.He distinguished between general radiology and interventional radiology when he alluded to the former as diagnostic in nature while the latter was more therapeutic in that it helped to "treat the patient."
Available to T&T for ten years
Ramroop said the process was still evolving and only came into widespread use "about 20 years ago" with only ten of those years afforded to the people of T&T.Admitting that many people were not fully educated on this medical specialty offered free through the public health authority, Ramroop said: "Surgeons may not be aware of what I'm offering so they use the old school of thought and operate on the patient where incisions are made and so on."I want to make people more aware so that they can put pressure on the doctors and ask them about this option."
Phenomenal treatment
One of Ramroop's patients, whose biopsy was witnessed by the Sunday Guardian, expressed no signs of pain during the eight-minute procedure, save for an anxiety reaction she (patient) endured at the sight of the biopsy needle that was used to extract a tissue sample.The Tobagonian patient had the procedure done (under ultrasound guidance) to test for cancerous cells and involved a minimally invasive session with the use of local anaesthetic.Among Dr Ramroop's specialities at EWMSC and at his private practice both at St Clair Medical Centre and St Augustine Private Hospital were: nephrostomy (bile and kidney drainage), stenting of blood vessels and arteries (for proper circulation), the draining of abscesses, cysts and conducting biopsies.He described one procedure-angioplasty-where an interventional radiologist inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin. The catheter is then threaded under ultrasound guidance to the site of a blocked artery where the balloon is inflated to open up the passage.
In some instances, Ramroop added, a small metal scaffold/tube called a stent, is inserted in order to hold the blood vessel open.The father of two said while he was aware that interventional radiology was competing with conventional surgery, he believed there was a place for them both and felt "they should work with each other" since it was necessary for some surgeries to be invasive given the nature and complexity of certain conditions.He added that while the procedures could be done for free, there were those patients who preferred to have it done privately in order to avoid the "red-tape" and various delays involved in referrals and scheduling of times to have the examination/surgery done.
Challenges in pioneering treatment
In alluding to some of the challenges he encountered having to pioneer this form of treatment in T&T (and possibly, the Caribbean), Ramroop revealed that some of these hiccups were the reason why he could not "do all the cases" he had been trained to do."I had to work very hard to get a catheterisation (cath) lab to use as an operating theatre for some of the more difficult procedures (such as angioplasty and stenting) to be done."It took about five years (2006) for us to get the use of two cath labs (at a cost of $21 million) but since they were not directly attached to our department, it was still difficult getting access to do all of the procedures," Ramroop said.He added that "it was very hard to initiate" given "the long list of consumables" needed and the fact that he had to "prove himself" convincingly to audiences that knew very little about interventional radiology. Ramroop said: "It's always difficult to bring new things on board, especially in our society because people are sceptical and even more particularly because there is no local person to whom they can compare my services with."
Meeting the Queen
Ramroop, who studied at the Royal Infirmary of Edinburgh, said his tenure of study in Scotland afforded him an audience with Her Majesty Queen Elizabeth II, who visited the facility ten years ago, during an official visit to the hospital's specialist departments.He said he had a conversation with Queen Elizabeth II for a few minutes where he informed her that he was from T&T and that he had specialised in interventional radiology.The past pupil of Fatima College said she (the Queen) was surprised (even impressed) by his negative response to her question as to whether he intended to further his concentration and research within the field abroad.Ramroop told her: "I plan to go back home because we don't have this type of treatment in medicine where I come from and I want to be able to impart this knowledge to my colleagues and peers for the overall benefit of the people of T&T."I want to give this option of tertiary healthcare to my people because they won't have it otherwise."He added, too, that a lot of people who specialised in Great Britain normally used the opportunity "to stay there and advance themselves because it was more lucrative," so that was why his response could have had the startling effect it did with the Queen.Ramroop said he was truly honoured to have had an audience with Her Majesty and heralded the moment as a once-in-a-lifetime achievement.He said: "It's something I will always remember and I have a picture to remind me of that experience."That is something I'm proud to boast about."