No CO2 required
Feasibility
Removes the need for general anesthesia
OUR TECHNOLOGY
A Surgical Lift System Enabling Gasless Laparoscopy In Low-resource Healthcare Facilities
Where laparoscopy is available, the predominant way to gain access is the insufflation of the abdominal cavity with CO2 gas. Although laparoscopy poses more benefits than open surgery, the use of CO2 in laparoscopy has challenges in reducing access to laparoscopy in low-resource areas, such as rural hospitals where only one surgeon per 2.5 million people is available. Some drawbacks include:
- Minimal/no availability of bottled gas
- Necessitates general anesthesia
- Sustainability concerns due to the use of CO2 and single-use instruments
- Expensive acquisition and maintenance of equipment
- Clinical contraindications: cardiac and respiratory complications
Because of these limitations, the World Health Organisation (WHO) has included gasless laparoscopy as an essential element of the WHO Compendium of Innovative Health Technologies.
These drawbacks present an opportunity to develop a low-resource gasless alternative to insufflation. We have developed a relatively inexpensive retractor that may be undertaken with spinal anesthesia and using modified reusable open surgical instruments through flexible gel ports.
Retractor for Abdominal Insufflation-less Surgery (RAIS) was developed by a collaborative multidisciplinary team of surgeons and engineers in the UK (University of Leeds) and India as an alternative to the existing CO2 use for abdominal visualization during laparoscopy. RAIS has been closely designed and evaluated with surgical experts working in low-resource areas. Our device works by mechanically lifting the abdominal wall, creating a space in the abdominal cavity to conduct laparoscopic surgery without compromising visualization. This device is clinically proven to be advantageous in the surgical room in several ways.
Removes the need for general anesthesia: Gasless laparoscopy with RAIS can be performed under spinal anesthesia, removing the need for catheter insertion, no post-operative confusion/cognitive dysfunction, and better patient comfort.
More than 1000 abdominal procedures have been successfully conducted using RAIS by surgeons in India, Kenya & Uganda. With publications and FDA approval in India and PPB in Kenya, RAIS is clinically and commercially proven to be scalable with impact.