Dr. Zine Abouelfadel

Breaking stone at the edge of himalayas
Meet the man who leaves no stone unbroken Nepal is bedrock of himalaya the ceiling of the world,this country is a piece of land surrounded by two giant asian powers india and china, both a challenge and opportunity of great people of this nation I had the opportunity of visting this country this summer, beside the desire to discover the country and its people,the beauty of its landscape and ancestral traditions but the main reason of my travel to this remote land was to pay visit to an exceptional person, a man who made me discover another dimension of Nepal medical innovation, he overcame the shortage of means by the abundance of creativity and determination to attain excellence, Dr Sanjay Khadgi a worldwide leader in minimally invasive kidney stone surgery, I first mat him in May 2016 at Paris challenges in Endourolgy meeting he does his surgery by mini percutaneous nephrolithotomy (NLPC ) using a small instrument called mini-nephroscope all the patients are operated under spinal anesthesia and usually feel comfortable throughout the procedure he gets access the caliciel system using fluoroscopy, he prefers the middle calyx since according to him the whole caliciel system could be explored through this puncture even stone of upper ureter but accessing from upper and lower calices are used according the situation, I saw him steering through the whole pelvicalcial system through a single access he blasts stone using the pneumatic device (lithoclast) and rarely uses the Laser Dr Sanjay set up his own guidelines that deserve to be taught at the schools of endourology worldewide Before the flight to dhangadi during my stay with him this summer I saw him performing more than 35 mini PCNL procedures, both in Kathmandu Vahyoda and Venus hospitals and at Dhangahi a small in far western Nepal to which we took a flight together and i had the pleasure to a have a glimpse into the himalaya from above the clouds, Majestic Himalayas
Performing a mini PCNL at Venus Hospital Kathmandu Dr Khadgi is used to fly once a month to take care of stone disease patient, and I saw the kind of admiration and respect people pay to him, in addition to attending surgery we discussed the idea of setting up a training program in mini-PCNL that will emcompass both a practice on a simulator and a hands-on training on the operating theatre ; it will be a great opportunity for those who want to combine good training to the discovery of a wonderful country.
This journey to Nepal was an eye opening and great discovery that people who struggle to attain excellence who works diligently to achieve it will ultimately be rewarded I myself enjoyed my stay and training Dr Kathgi and I will strongly recommend his training program to all urologists with special interest in this technique once this is up and running
Zine Abouelfadel, MD
Agadir, Morocco