San Marcos Mercury | Local News from San Marcos and Hays County, Texas
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Charla Changos got a tattoo recently. You couldn’t see it because it was under the Buda veterinary technician’s skin. Under her ribs, too.

The tattoo, called a “pleural surface marking,” was etched on the outside of her left lung by Dr. Kalpesh Patel of Kyle – without having to break through Changos’ ribcage. He used a highly unusual medical technique – apparently for the first time ever in Hays County – using “Super D,” GPS-like technology with remote-controlled, microsurgical tools to enter the patient’s body arthroscopically, under her shoulder blade.

The only person who needed to see the three tattooed dots that formed a triangle was another local surgeon, Dr. William Kessler, who basically used it like a treasure map. “X,” indeed, marked the spot: Under the lung tissue pinpointed between the three dots was a dark spot where Kessler obtained a biopsy to determine if the discolored area was cancerous.

If Patel hadn’t been able to mark the area, and if Kessler hadn’t been able to then get the biopsy, Changos would never have learned if the dark spot was malignant or not. Usually, a spot so difficult to reach would remain a mystery for the patient.

The good news: the biopsy showed the spot is not cancerous. Just as good: because no major incisions were necessary, Changos was quickly back to resuming her normal activities at work and home.

“I felt so much better so quickly,” Changos said. “I’ve had more energy than I’ve ever had. It was such a relief to find out it wasn’t cancer. I don’t think I could have lived not knowing that, and it’s taken a lot of stress off me.

“I know cancer,” she said, recalling her grandmother had a spot on one her lungs for 25 years that ultimately became malignant. “It can be slow going or go off like a firecracker. If it’s a growth in my body that shouldn’t be there, let’s check it out.”

But she adds that, if major surgery had been required to reach this spot, she might have waited. Instead, she had “two little holes in my back and one in my side and the two in the back healed pretty quickly” and she was back to work within days.

Patel, a Seton Medical Center Hays pulmonologist and critical care specialist, practices at Hays Pulmonary & Sleep Associates in Kyle. He learned and successfully performed his tattooing technique as part of a dedicated year and half training in interventional pulmonology at Franklin Square Hospital in Baltimore. He had performed similar procedures several times before Changos became his first Hays County patient getting this procedure.

“Medical technology has advanced to where major surgery often can be avoided, along with months of recovery time – and this procedure now can be done locally,” Patel said.

The “Super D” system, formally called i·Logic Inreach by superDimension, employs what is called electromagnetic navigation bronchoscopy technology. Through proprietary software and electromagnetic technology, i·Logic enables physicians to use a small, steerable catheter inserted through the bronchoscope and guided by GPS technology to a specific spot in the body. The “Super D” system was installed last year at Seton Medical Center Hays.

STEVE TAYLOR works for Seton Family of Hospitals.

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