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

被引:4
作者
Oosting, R. M. [1 ]
Ouweltjes, K. [2 ]
Hoeboer, M. D. B. [1 ,2 ]
Hesselink, L. [2 ]
Madete, J. K. [3 ]
Diehl, J. C. [2 ]
Groen, R. S. [4 ]
Wauben, L. S. G. L. [5 ]
Dankelman, J. [1 ]
机构
[1] Delft Univ Technol, Dept Biomech Engn, Mekelweg 2, NL-2628 CD Delft, Netherlands
[2] Delft Univ Technol, Dept Design Engn, Landberghstr 15, NL-2628 CE Delft, Netherlands
[3] Kenyatta Univ, Dept Elect & Elect Engn, Sch Engn & Technol, Kenya Dr,POB 43844-00100, Nairobi, Kenya
[4] Johns Hopkins Univ, Dept Gynecol & Obstet, 601 N Caroline St, Baltimore, MD 21231 USA
[5] Rotterdam Univ Appl Sci, Res Ctr Innovat Care, Rochussenstr 198, NL-3015 EK Rotterdam, Netherlands
来源
JOURNAL OF MEDICAL DEVICES-TRANSACTIONS OF THE ASME | 2020年 / 14卷 / 01期
关键词
surgical equipment; electrosurgery; global surgery; low- and middle-income countries; CAPACITY; HEALTH; OPPORTUNITIES; SURGERY; INDEX;
D O I
10.1115/1.4045966
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
To comply with the large global need for surgery, surgical equipment that fits the challenging environment in low- and middle-income countries (LMICs) should be designed. The aim of this study is to present a context-specific design of an electrosurgical unit (ESU) and a monopolar handheld to improve global access to surgery. This paper presents both a detailed description of electrosurgery in clinical practice in LMICs and the design of an ESU generator and monopolar handheld for this specific setting. Extensive fieldwork (by means of surveys, interviews, observations, and collection of maintenance records) was done by authors RO, KO, and LH. Feedback from users working in Kenya on the first demonstrator designs was obtained, after which the designs were adapted into conceptual prototypes. These were further evaluated by surveying respondents who attended the annual meeting of the College of Surgeons of East, Central, and Southern Africa (COSECSA) in Kigali, Rwanda in December 2018. Conceptual prototypes were developed for (a) an affordable ESU that is compact and battery powered and (b) a robust reusable monopolar handheld that can be cleaned in the autoclave and by chemicals (e.g., glutaraldehyde solution). The conceptual prototypes were positively received by the 51 respondents of the survey. The findings from the field work and the feedback from users during the design phase have led to a clear understanding of the specific needs and potential solutions. The presented conceptual prototypes need to be further developed into functional prototypes, which could be implemented in Kenya and other settings for further evaluation.
引用
收藏
页数:12
相关论文
共 28 条
[1]  
[Anonymous], 2018, PROC IEEE GLOBAL HUM, DOI DOI 10.1109/GHTC.2018.8601913
[2]  
[Anonymous], 2012, P NOTHERN WORLD MAND
[3]  
[Anonymous], GLOBAL CLIN ENG J
[4]   Survey of Surgery and Anesthesia Infrastructure in Ethiopia [J].
Chao, Tiffany E. ;
Burdic, MacKenzie ;
Ganjawalla, Karan ;
Derbew, Miliard ;
Keshian, Christopher ;
Meara, John ;
McQueen, Kelly .
WORLD JOURNAL OF SURGERY, 2012, 36 (11) :2545-2553
[5]   Electricity and generator availability in LMIC hospitals: improving access to safe surgery [J].
Chawla, Sagar ;
Kurani, Shaheen ;
Wren, Sherry M. ;
Stewart, Barclay ;
Burnham, Gilbert ;
Kushner, Adam ;
McIntyre, Thomas .
JOURNAL OF SURGICAL RESEARCH, 2018, 223 :136-141
[6]   A cross-sectional survey of essential surgical capacity in Somalia [J].
Elkheir, Natalie ;
Sharma, Akshay ;
Cherian, Meena ;
Saleh, Omar Abdelrahman ;
Everard, Marthe ;
Popal, Ghulam Rabani ;
Ibrahim, Abdi Awad .
BMJ OPEN, 2014, 4 (05)
[7]   Problems with systems of medical equipment provision: an evaluation in Honduras, Rwanda and Cambodia identifies opportunities to strengthen healthcare systems [J].
Emmerling, Dane ;
Dahinten, Alexander ;
Malkin, Robert A. .
HEALTH AND TECHNOLOGY, 2018, 8 (1-2) :129-135
[8]   Minimum Specifications for a Lifebox Surgical Headlight for Resource-Constrained Settings [J].
Forrester, Jared A. ;
Torgeson, Kris ;
Weiser, Thomas G. .
JAMA SURGERY, 2019, 154 (01) :80-82
[9]   A Tool and Index to Assess Surgical Capacity in Low Income Countries: An Initial Implementation in Sierra Leone [J].
Groen, Reinou S. ;
Kamara, Thaim B. ;
Dixon-Cole, Richmond ;
Kwon, Steven ;
Kingham, T. Peter ;
Kushner, Adam L. .
WORLD JOURNAL OF SURGERY, 2012, 36 (08) :1970-1977
[10]   A Survey of Surgical Capacity in Rural Southern Nigeria: Opportunities for Change [J].
Henry, Jaymie A. ;
Windapo, Olubayo ;
Kushner, Adam L. ;
Groen, Reinou S. ;
Nwomeh, Benedict C. .
WORLD JOURNAL OF SURGERY, 2012, 36 (12) :2811-2818