Science for the benefit of people. All people. Worldwide.
We’ve all been there. You have had an accident, perhaps bruised or broken a limb. Off you go to the accident and emergency department at the hospital. In Africa things are not quite that straightforward. 85% of all 15 year-olds who needed a minor or more important surgical intervention at one point did not get it. Treatment, if available at all, is often at a couple of days travel. Often that is simply too long and patients are left with impairments varying from minor to life-changing, or even die. Worldwide a lack of access to basic healthcare kills more people than malaria, HIV/aids and tuberculosis put together. That is why Jenny Dankelman’s TU Delft Global project is all about developing safe and affordable surgical instruments.
The most complex of these is an electrosurgical device used to make incisions and cauterise wounds. After cutting, blood loss is kept to a minimum by cauterising the wound as quickly as possible. “Even for Western doctors it’s not the easiest of instruments. It has different settings for cutting and cauterising. Research shows that surgeons don’t always know exactly what the different settings mean. As a result the device is sometimes used inappropriately and that can have serious consequences.” These devices also find their way to developing countries. Clinical surgery departments have been involved in numerous efforts to raise funds for training local doctors to use them. “But I prefer to focus on the device, not the person who’s using it. Why not make the device easier to use? That is how my group works: we try to find simple solutions. Moreover, apart from use, maintenance, the replacement of parts and an unstable electricity supply can also be a problem in developing countries. That is why I’m concentrating on technology rather than instruction, so we’ll end up with a better instrument.” Robot technology is a hot topic in Dankelman’s field of expertise. “That kind of technology is not always the best way forward. For maximum impact you want to keep things affordable and simple, especially in developing countries where healthcare budgets are very limited. And that is what we are aiming for in this TU Delft Global Research Fellowship.” Dankelman projected development time for a fast, compact and reliable device is four years. This device will be user-friendly and will continue to work during power outages.
Dankelman’s project partner is the Female Cancer Foundation which has developed a technique to treat cervical cancer in developing countries. “I am a complete novice when it comes to doing work for developing countries. I will learn from the experience of the Female Cancer Foundation which has already set up projects in several African countries, India and Indonesia.” Dankelman is planning a number of initial research and testing sessions in Indonesia where she will be liaising with Delft University of Technology PhD graduate Dr Suprianto who is also researching electrosurgery there.
This TU Delft Global project is only the start, Dankelman says. A professor of Minimally Invasive Surgery and Intervention Techniques she knows all there is to know about operating through small holes, or ‘keyhole surgery’ as it is popularly known. Using smart needles and flexible catheters means incision size can be brought back considerably, keeping the risk of infection to a minimum. Dankelman’s goal is to start several projects around the improvement of surgical instruments for developing countries. “I would start with instrument and operating room sterility issues. But ultimately I would like to take the step from open surgery to minimally invasive surgery.”
Global Research Fellowship
Make basic surgery available for everyone
Affordable and high quality equipment for basic surgery
The Female Cancer Foundation (Indonesia, Africa)