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Session: Surgery & Intervention
Session starts: Friday 27 January, 14:00
Presentation starts: 15:15
Room: Room 531

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Roos Oosting (Delft University of Technology)
Jenny Dankelman (Delft University of Technology )

Abstract:
The need for surgery in low- and middle-income countries (LMICs) is tremendous; more people die from treatable surgical conditions than from tuberculosis, malaria and HIV put together (1). As such, patients in these regions can benefit from minimally invasive surgeries (MIS) with its reduction in pain and operation time, length of hospitalization, and morbidity compared to open surgical techniques. There is a growing interest in MIS in most LMICs, but its widespread adoption has been challenging due to high start-up costs, lack of technological support, and limited access to training (2). To overcome these barriers, we see a huge opportunity and need for biomedical engineers from all over the world to contribute to increasing access to safe (minimally invasive) surgery on a global scale, which is also more and more endorsed by the international community of biomedical engineers (3). For the last 5 years, we have been working on various projects in the field of Biomedical Engineering for Global Health within the department of Biomechanical Engineering at the TU Delft in collaboration with biomedical engineers and surgeons working in Kenya, India, Surinam, Malawi, and Nepal. We conducted various context studies to understand the context of use (4-6), and we worked on a context-driven design approach to support engineers working on innovations for LMICs settings (7) and various prototypes for example a novel context-specific electrosurgical device (8), a video laryngoscope using a USB camera and mobile phone, a manual vacuum pump (all currently under development by the spin-off company Layco Medical) and a dozen graduation projects on various solutions for global health. One of our studies (6) revealed that the light source and cameras used during MIS are prone to breaking, we are therefore currently developing a laparoscope using a USB-Camera connected to a laptop or tablet that provides enough light for diagnostic purposes and small laparoscopic surgeries. Prototypes are currently under development and our aim is to perform user tests on a large Innovation for Global Surgery conference in Kenya in April 2023. 1. Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet. 2015;386(9993):569-624. 2. Gheza F, Oginni FO, Crivellaro S, Masrur MA, Adisa AO. Affordable laparoscopic camera system (ALCS) designed for low-and middle-income countries: a feasibility study. World journal of surgery. 2018;42(11):3501-7. 3. De Maria C, Díaz Lantada A, Jämsä T, Pecchia L, Ahluwalia A. Biomedical engineering in low-and middle-income settings: analysis of current state, challenges and best practices. Health and technology. 2022:1-11. 4. Oosting RM, Wauben LS, Mwaura SW, Madete JK, Groen RS, Dankelman J. Barriers to availability of surgical equipment in Kenya: A surgical equipment journey approach. Global Clinical Engineering Journal. 2019;1(2):35-42. 5. Oosting R, Wauben L, Groen R, Dankelman J. Equipment for essential surgical care in 9 countries across Africa: availability, barriers and need for novel design. Health and Technology. 2019;9(3):269-75. 6. Oosting R, Wauben L, Madete J, Groen R, Dankelman J. Availability, procurement, training, usage, maintenance and complications of electrosurgical units and laparoscopic equipment in 12 African countries. BJS open. 2020;4(2):326-31. 7. Oosting R, Dankelman J, Wauben L, Madete J, Groen R, editors. Roadmap for design of surgical equipment for safe surgery worldwide. 2018 IEEE Global Humanitarian Technology Conference (GHTC); 2018: IEEE. 8. Oosting R, Ouweltjes K, Hoeboer M, Hesselink L, Madete J, Diehl J-C, et al. A context-specific design of an electrosurgical unit and monopolar handheld to enhance global access to surgical care: a design approach based on contextual factors. Journal of Medical Devices. 2020;14(1).