Development of affordable minimally invasive endoscopic surgical tools for resource constrained operating rooms

Project reference: DTP_SIE_14 This project has already been allocated and is no longer available for applications
First supervisor: Prashant Jha 
Second supervisor: Hongbin Liu

Project summary: Five billion people do not have access to safe surgery, two billion have no access at all, and three billion have access to some kind of surgery, but it is not really safe. Lack of surgery and also poor surgical conditions are neglected global health problems affecting the world’s poorest people. In Lower, Middle-Income Countries (LMICs), operative mortality is high (5–10%), with the majority related to infections, anaesthesia complications, and haemorrhage. 


Project description: It has been shown that, even in low-resource settings, Minimally Invasive Surgery (MIS) would provide many advantages over open surgery, such as decreased risk of infection, decreased blood loss, reduced postoperative pain, improved bed utilization, shorter hospital stay and rapid return to work. These advantages are even more important in low-resource settings where sanitary conditions are poor, blood banks not available and distances to hospitals are large. 

Compared to open procedures, the MIS procedure implies many limitations for the surgeon. Long instruments are inserted through a small incision, resulting in limited movement possibilities, and in scaling and mirroring of movements. An endoscope (camera) is inserted presenting a 2D image on the screen. Due to misalignment of the natural line of sight with the camera orientation, misorientation can occur, limiting the ease of manipulation of the instruments. To improve tissue manipulation capabilities, better tip/tissue alignment due to a steering mechanism between tip and shaft is needed as found in e.g. robotic surgery; however, it is not feasible to use complex and expensive robotic master-slave systems in hospitals in LMICs. 

We propose to develop a surgical equipment system which will allow minimally invasive surgery without the need for a sterile operating room and will have lesser dependence on operator skills. We will use a human-centric design approach and co-creation involving clinicians, designers, entrepreneurs and engineers to develop easy-to-manufacture, easy-to-use and easy-to-clean instrument. Prototype testing will be done together with clinical groups in South Asia / Africa, (new) spin-off companies and surgical device certification experts. After benchtop/cadaver testing, the developed instruments will be ready for pilot clinical testing.

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