Title
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
Author
Oosting, R.M. (TU Delft Medical Instruments & Bio-Inspired Technology) 
Ouweltjes, Koen (Student TU Delft)
Hoeboer, M.D.B. (Student TU Delft)
Hesselink, Larissa (Student TU Delft)
Madete, J.K. (Kenyatta University)
Diehl, J.C. (TU Delft Design for Sustainability)
Groen, R. S. (Johns Hopkins University)
Wauben, L.S.G.L. (Rotterdam University of Applied Sciences)
Dankelman, J. (TU Delft Medical Instruments & Bio-Inspired Technology)
Date
2020
Abstract
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.
Subject
Surgical equipment
electrosurgery
global surgery
low- and middle-income countries
To reference this document use:
http://resolver.tudelft.nl/uuid:ddd863f5-d0c4-46d0-aa9a-0c16a7946e05
DOI
https://doi.org/10.1115/1.4045966
Embargo date
2020-08-05
ISSN
1932-619X
Source
Journal of Medical Devices, 14 (1)
Bibliographical note
Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.
Part of collection
Institutional Repository
Document type
journal article
Rights
© 2020 R.M. Oosting, Koen Ouweltjes, M.D.B. Hoeboer, Larissa Hesselink, J.K. Madete, J.C. Diehl, R. S. Groen, L.S.G.L. Wauben, J. Dankelman