MIS WITH FRUGAL INNOVATIONS & VIRTUTAL REALITY TRAINING

The Lancet commission on Global surgery estimates the need for surgical care at five thousand procedures per one hundred thousand population a year. This figure is about three hundred in rural areas. Inadequate infrastructure and lack of trained personnel are the main impediments in rural areas. Our innovative solutions address both problems. Minimally Invasive Surgeries (MIS) make efficient use of the meager facilities available in rural areas. The innovative Gas Insufflation Less Laparoscopic Surgeries [GILLS] address the other need of lack of General anesthesia in rural surgical facilities. The Laptop Cystoscope offers a very low-cost investment for diagnostic and minor Urological procedures at a fraction of the cost of conventional equipment. Our low - cost imagining system similarly connects to the laptop computer and replaces the highly priced laparoscopic tower. Our realistic Simulator for learning GILLS and rural urology and the use of virtual reality for training is a extremely low-cost method of training. The 360 camera and several inlays of the monitor, close view camera and other training materials give the trainees the best possible position next to the surgeon in the operating room virtually. 

The following are the ways in which our solutions address the problems

1. Minimally Invasive Surgeries like Laparoscopic Surgeries and Rural Urology can increase the surgical coverage by 1200 per one hundred thousand population a year. This uses the meager rural surgical facilities efficiently. 

2. Gas Insufflation Less Laparoscopic Surgeries are possible under easily available and low-cost spinal anesthesia by lifting the abdominal wall using special equipment. 

3. The Laptop Cystoscope just connects to the laptop computer and avoids the use of expensive telescopes, cameras, light sources, and monitors by replacing the telescope with an endo-cam. 

4. The specially designed low - cost camera for laparoscopic surgery is placed on the ring used for GILLS surgeries thus doing away with the expensive parts of the conventional laparoscopic towers and the need for an intelligent assistant to hold the camera

4. The virtual reality videos help in first learning of the rural surgeons from remote locations and supervised skills learning with short contact programs. Follow up monitoring after learning is possible through these virtual reality methods. It is a scalable low-cost model. Simulators for learning laparoscopic surgery and urology are available at the local place along with virtual reality training videos.

Teaching videos and methods are available in the following links

https://www.youtube.com/@rural...

https://www.vrims.net/

The target population is the rural surgical patients and doctors working in rural health care faciliteis in rural and remote areas. Our solutions will empower the rural surgeons to offer the Minimally Invasive Surgical procedures at a small fraction of the costs at the urban hospitals and the patients need not travel to the urban centers, spend money, and get below the poverty line. 

The Association of Rural Surgeons of India formed the Rural Surgery Innovations Private Ltd to receive the small grant from the Indian government to work on the laptop cystoscope. The team had earlier worked both with the Millennium Alliance grant and a project from the University of Leeds to develop the Gas Insufflation Less Laparoscopic Surgeries and the VRiMS team from UK to develop the courses for virtual reality training.

The members of the Association of Rural Surgeons of India work in rural and remote areas our country

We have developed the prototype for Gas Insufflation Less Laparoscopic Surgery and did a randomized control trial to show non inferiority compared to the conventional laparoscopic surgeries. We are doing similar studies for the Laptop Cystoscope. The simulator prototype is ready for testing and the courses are being prepared for the virtual reality training program

The reason for applying is for getting these solutions to Africa and other LMICs all over the World so that they can benefit like the rural areas in India where these frugal innovations are used

Our solution addresses the problems in rural surgical care by innovative methods

1. Our solutions make Minimally Invasive Surgeries affordable, available, and accessible by the innovative training methods (using virtual reality), innovative techniques (laparoscopic surgery under spinal anesthesia) and innovative cost reduction methods (use of low cost cameras instead of using expensive telescopes and conventional cameras)

The penetration of Laparoscopic surgeries despite all the advantages is only 10% and the endoscopic urology surgeries 2%, primarily because of the exorbitant costs. Our solutions have the potential to reach the other 90 to 98% of the rural health care facilities all over the World

The primary impact would be the improved surgical coverage in the target population of the rural health care facilities calculated at number of surgical procedures per one hundred thousand population a year

The technology of our solutions uses the locally available and low-cost facilities to offer high quality surgical care. The local availability of the solutions in rural areas significantly reduce the carbon footprint by dramatically reducing the travel required to get the Minimally Invasive Surgeries in urban areas with equipment that are expensive

We have three full time staff, ten health care facilities where the part time volunteers work and 15 interns work

We started the work on Gas Insufflation Less Laparoscopic Surgeries in 2015 and Laptop Cystoscope in 2019 and Virtual reality and Simulator last year

Rural Surgery Innovations report to the Association of Rural Surgeons of India and International Federation of Rural Surgeons with diverse members and recently to International Collaboration for Innovations in Global Surgery

I have enrolled in the online course

The sale of equipment and revenue from training programs