Twenty-year-old Tosin Ojelabi became ill in 2015, she was diagnosed of Budd–Chiari which she had been suffering from for three years. In the past, the only way to treat Budd-Chiari syndrome was a large operation with surgery creating “a mesocaval shunt”, a shunt from the big veins in the belly to the inferior vena cava.
Tosin suffered a significant amount of fluid build-up in the abdomen with up to 33 litres drained from the belly monthly and had significant muscle wasting. She simply lived a life none of us want to live. It was then the test revealed that not only did Tosin have the rare disease, but that she badly needed a surgery.
Budd–Chiari syndrome is a disease where there is obstruction of the venous outflow from the liver either at the level of the hepatic veins (blood vessels that carry blood black to the heart). When this obstruction occurs, all the blood coming from the abdominal organs and bowels into the liver have nowhere to go. This results in congestion of the liver and backflow of blood into the abdomen. This pressure results in massive fluid build-up in the abdomen called Ascites.
“We successfully performed the TIPS shunt. The procedure was technically challenging and required modified techniques with thinking outside the box, but the expertise was available to tackle all of this which ensured success,” said the team of surgeons, led by Hammed Ninalowo, Vascular and Interventional Radiologist, at Euracare Multi-Specialist Hospital, in Lagos.
According to the team of surgeons, Budd–Chiari syndrome cause is largely unknown, but is usually attributed to a hyper thrombotic state or a web. “Our patient did well and was discharged home the next morning. This procedure was only previously done with a major operation, which would have required time in the intensive care unit and significant hospitalization time after surgery,” Ninalowo explained.
However, the first liver bypass surgery without cutting the patient open was performed at Euracare Multi-Specialist Hospital Lagos. The procedure called a Trans jugular intrahepatic Protosystemic shunt (TIPS) is one that uses imaging guidance to connect the portal vein to the hepatic vein in the liver was the first of its kind performed in Nigeria or sub- Saharan Africa.
“It’s exciting to be able to perform the first TIPS procedure in Nigeria. With various techniques such as angiography, angioplasty, stenting, thrombolysis, embolisation, ablation, we are happy to provide an alternative procedure for patients, one that is favourable for the patient,” Ninalowo said.
Also speaking on the breakthrough, Tosin Majekodunmi medical director at Euracare, stressed that the success of the procedure is testament to Euracare’s innovation and professionalism, stressing the hospital’s commitment to reducing medical tourism by Nigerians. “As the leading multi-specialist hospital in Nigeria, we are committed to providing excellent care for our patients and procedures like TIPS, which require complex interventional radiology, allow us to showcase our expertise especially to people who normally would prefer to travel abroad for procedures.”
Interventional radiology treatments can be the first-line care option for a wide variety of conditions like blocked fallopian tubes, malignant tumours in lung and liver cancer, fibroids and non-healing ulcers on diabetic patients. Interventional Radiology treatments do not involve open surgery allowing for small to no incisions, short hospital stay, quick recovery time, less scarring, reduced blood loss and reduced apprehension.
Commenting on improving Public Private Partnership (PPP) in Nigeria’s health sector, Baiyewu Lateef Ayodele, a Surgeon – Cardiothoracic, said it is a new way to go to drive this new innovation in the county’s healthcare delivery services generally.
“There is no way the government can fund everything in healthcare alone because the demands are not full taken care of by the supply by the government , so there is a definite need for collaborations and partnerships with private arm of investment in healthcare to strengthen and fill gaps in the sector,” he said.
ANTHONIA OBOKOH
