With steady hands and X-ray vision, Dr. Bandt is known for performing the first of a life-saving procedure in Nevada
When Paul Bandt graduated from medical school at the University of Minnesota in 1966, he couldn’t have imagined the future of his work. Even as a diagnostic radiology resident at Stanford Medical Center, he couldn’t have fathomed the exploding future of his field. Nobody could have.
Intrigued by the ability to diagnose and treat things that were hidden to the naked eye, but apparent through X-ray, Bandt chose to sub-specialize in interventional radiology, using image guidance to perform minimally invasive surgery. At the time — when there were no such things as diagnostic ultrasounds or CAT scans — his work was primarily fluoroscopy, an imaging technique incorporating X-ray and fluorescence. Then came the advent of three-dimensional imaging, computer demographic scanning, magnetic resonance scanning and ultrasound scanning; physicians suddenly had the ability to clearly see inside the body in 3-D. The field of interventional radiology ignited. Suddenly, radiologists were able to do things never before done and interventional radiology evolved into a type of surgery.
“That became intensely fascinating,” says Dr. Bandt, an interventional radiologist at Desert Radiologists (desertradiologists.com). “To be able to treat these patients who previously had required really large surgical procedures. And we were able to do them in out-patient procedures.”
Now with the latest in medical imagery, Bandt commonly treats arterial malformations in the vascular system. He diagnoses, dilates and treats arterial blockages in the brain or the renal arteries. He drains cysts or abscesses to avoid operative procedures. He performs biopsies via needles anywhere in the body.
Interventional radiology has since surged into nearly every other area of medicine. “It was truly interventional radiology that pioneered this whole idea of doing things on a minimal basis with image guidance,” Bandt says, pointing to surgeon’s and fiber-optic scopes in his office. When asked what sets him apart as a top doctor, he’s humble. “Just because there are people picked out as the 10, 20 or 30 top doctors, there are 10 times that many who practice the same skill with the same results.”
But, when pressed, he admits that aptitude and agility are important. “It’s like anybody doing anything, whether it’s a ballplayer or a violinist, you have to have a certain aptitude and agility with your hands, and coordination and all those things. ... If there’s something that sets you apart, maybe it’s just a matter of what you’re doing, where you’re doing it and that you get a chance to do procedures in large volumes, so you become expert at it. That’s really the secret.”
Most doctors who earn recognition for being the best, Bandt says, work 10- and 12-hour days and 50-hour weeks. “We all have to thank our families for putting up with dad not being around a lot of times,” he says, grateful that his younger colleagues now afford him the luxury of weekends off.
In 1991, when he was still working weekends, Bandt performed the first TIPS shunt (transjugular intrahepatic portocable shunt) in Nevada. Traditionally, the operation necessary to treat a patient with liver failure had a high morbidity (disease) and mortality rate. But the TIPS shunt, which creates an artificial channel within the liver to allow the blood to get back to the heart more easily, has a significantly higher success rate.
“The patient was bleeding to death and you just had to do it,” Bandt recalls of the heavy drinker's delicate situation. “The surgeons refused to do it because the patient had such bad lungs that he couldn’t take the general anesthesia. It had to be done with conscious sedation,” or the patient would die within 68 hours.
Although the procedure was essentially a combination of everything that interventional radiologists did, at the time, it wasn’t clear to Bandt how it all came together. The FDA had only a month earlier approved the stent needed for the procedure; it had been performed only 10 or 20 times in the country. “There wasn’t anybody to hold your hand. You just had to watch the videos of how it’s being done and that’s about it.”
The surgery was a success. A month later, Bandt’s 35-year-old patient walked out of the hospital. The patient hasn’t had a drink since — although we don’t imagine his hands are as steady as the good doctor’s.