FMDH Offering New Procedure And Technology To Patients

Frances Mahon Deaconess Hospital has added a new procedure and new technology to help patients with their gallstone needs instead of having to travel to Billings. ERCP, also known as endoscopic retrograde cholangiopancreatography, provides the ability to better treat gallbladder and gallstone issues. Due to this procedure, new technology, a disposable duodenoscope, was also obtained to ensure the most sanitary experience for the patient.

"There have been problems overall with duodenoscopes because you put tools and stuff down them. There is a little mechanism that is used to manipulate the tools. Bacteria and stuff get stuck in there and after trying different cleaning protocols and multiple washings, nothing cleans them adequately," stated FMDH General Surgeon Dr. Nicole Lorenz. "There's been drug resistant organisms that have been infecting people so it will start to be a requirement that disposable scopes be used but it can't be possible until readily available."

FMDH is the third facility in the country, behind Seattle and Denver, to have the disposable duodenoscope and Billings is the closest facility to perform the ERCP procedure. "Boston Scientific, the company that supplies us with the equipment, said there's no one from Bismarck on over. They weren't even sure how far west you would have to go from Glasgow to hit somebody on the Hi-Line that does it and as far east as you'd have to go is over towards Bismarck. So it's a huge area that is not serviced with this kind of procedure," explained Director of Surgical Services Brooke Martin.

The first procedure was done on May 12, though it wasn't the first procedure Dr. Lorenz has done, it was the first for FMDH surgical staff.

"For me it was just a standard ERCP. The equipment was a little stiffer because it's brand new. I was impressed with how everybody did. It went better than I expected for a first time run of the ERCP. I think it went quicker for everybody. Everybody expected to go longer," stated Dr. Lorenz. Martin agreed with how quickly it went stating, "The rep from Boston Scientific came up from Salt Lake City to be with us, to help us through the procedure if we needed him. He looked down and about missed it!"

The surgical staff received extensive training from Boston Scientific who made a visit to Glasgow in December and spent three days with the surgical staff. The first two days consisted of the trainer with Dr. Lorenz, providing feedback, while the third day involved the entire staff.

"They brought scopes to use, they brought slideshows, they brought all of the equipment that we would be using so that we could physically practice the process, obviously without a patient. He had simulators that we were able to feed the scoping instruments through and then he left all practice equipment with us and so between December and now we did lots more practicing and running through things," explained Martin.

Leading up to the first surgery day, the team sat down and talked over expectations and steps to expect during the surgery and also was involved in a Zoom meeting with Boston Scientific reps where equipment was walked through to ensure everything was in good working order.

According to Lorenz, the first patient was very pleased with how the procedure went and equally excited he didn't have to travel to Billings to get it done. The patient, who had to have to complete two procedures, "was actually sad he didn't get in on his first procedure here!" Dr. Lorenz exclaimed.

This new procedure and technology was brought to FMDH as a result of Dr. Lorenz's capabilities and technical skills on being able to utilize the side-viewing scope, which is necessary in ERCP. "Lots of general surgeons do regular endoscopy where you're looking through the front of the scope and doing colonoscopies and do those kinds of things, but to have a general surgeon, with her skills, is a huge deal for our area, period. We never had that technology before we had Dr. Lorenz and then we knew that was something special she was bringing to us," explained Martin.

Martin expressed thankfulness Boston Scientific was open to travel to the Middle of Nowhere and help FMDH get this new technology and procedure set up.

"We're small potatoes for them, you know compared to Denver, San Francisco and Seattle. Glasgow, Montana is small potatoes, but they knew our story and they knew what kind of area that we were servicing and they knew what a huge deal it was to be able to offer this to our patients so they didn't have to travel for this. They were just really really excited and on board from last fall when Dr. Lorenz got here. A lot of the reason why we have this ability is because they understood the impact to the community," she explained.