Innovations
Innovation is part of life.Innovation but not imitation has changed our society.In the field of medicine we should never forget our socioeconomic background& ethics.Medical science is a discipline where social science & natural science are closely interwoven.Many a times we face challenges in managing different diseases.The hurdles may be technical or socioeconomic.We have to face the challenges & overcome them by innovation. Innovation in our discipline is an effective weapon to meet these challenges.Innovation is the fruit of our spirit & conviction
Innovations
Corrosive acid ingestion & acid stricture of esophagus(food pipe) is a dreadful disease .In India particularly in West Bengal many young female resort to suicidal attempts by swallowing acid & suffer from this problem. They cannot take food not even swallow saliva.The situation is horrible.These patients mostly come from a poor socioeconomic background & suffer a lot.They are managed surgically by constructing an alternative food pipe with the help of large gut(colon).The surgery is known as colon by pass surgery.Even after this surgery they may develop some complications & cannot take food.The options to treat these complications are technically demanding & expensive.In those patients Buccal Mucosal Grafting(BMG)in coloesophagoplasty is a technique which help the patients.It is a simpler & less expensive technique.This technique has been innovated by Dr Amitabha Chakrabarti & it has been published in Indian Journal Of Surgery(IJOS).Till date more than 18 young girls & boys have been treated by this technique & living a fairly decent quality of life.
Managing recurrent pleural effusion with trapped lung
Many patients suffer from recurrent pleural effusion(collection of fluid inside chest cavity).Usually they are treated by drainage of fluid,medicines & surgery.But in some patients they fail to subside.Particularly in some patients suffering from lung cancer & kidney failure with non expanded lung,.These patients are treated by indwelling pleural catheter with valve.These are imported costly products not easily available in India.We have developed an ingenious cheaper alternative instrument by utilizing Foley’s urinary catheter.This helps to manage the patient & allows them to go home early.
Mediastinoscope
Mediastinum is the central compartment of chest cavity.Mediastinoscope is an instrument which is used to diagnosel lymphatic diseases & tumours located in mediastinum.It may also be used to treat cystic lesion of mediastinum.Modern mediastinoscopes have inbuilt telescopes .They are very costly.We have deviced an ingenious mediastinoscope with a direct laryngoscope & use it with the help of a 4mm telescope which is commonly used in arthroscopy & Nasal endoscopy.this telescope is available in most of the hospitals nowadays so we need not buy them.Without telescope the cost will be about Rs.3000 to 4000.telescope will cost anotherRs.50000-70000 extra.That also we need not buy in most of the situations.But a mediastinoscope with inbuilt telescope will cost about Rs.2-3 lakhs
Palm breadth incision for clotted hemothorax
Palm Breadth incision for thoracotomy:Many a times we find patients who have multiloculated pleural collection & blood clots ,particularly after Open heart surgery.These patients with midline sternotomy incision & in serious clinical condition sometimes cannot be successfully treated by chest tube drainage or ultrasonography guided aspiration.In those patients surgical treatment is necessary.But as the patient is having a cut across midline bone a conventional thoracotomy will add much pain to the patient.Patient will have difficulty in breathing .On the other hand VATS is also difficult in these seriously ill patient because many of them are unstable & do not tolerate single lung anaesthesia which is required in VATS.In that situation we have innovated a novel technique-Palm Breadth Incision Thoracotomy.The principle is if you can introduce your palm inside chest cavity of the patient then you will be able to remove clots,break loculi & remove the chest collection satisfactorily.Based on this we have operated more than 80 such patients over last 10 years.The incision is small,post operative pain is less,operative time much less compared to VATS or conventional thoracotomy. The recovery is faster,hospital cost is also less.
technique of self dilatation of pharyngeal stricture
Corrosive acid injury patients many a time have severe acid burn injury in upper esophagus & pharynx.They cannot swallow liquids even their own saliva.To repair upper food passage frequent balloon dilatation is performed.They incur a high procedural cost on those patients who usually come from economically challenged situation .The expenses also rise due to regular hospital visit. We have innovated a self dilatation technique to repair upper food passage.A Foleys catheter is passed through nostril to the narrowed segment of pharynx & upper esophagus.The patient is trained to inflate the balloon of Foleys catheter which while passing through the narrowed segment eventually dilates the food passage .This self dilatation technique regularly done by the patient at his or her house helps to prepare proximal part of food passage & finally allows a successful coloesophageal or colopharyngeal by pass surgery.
This is a photograph in an ancient Egypt temple,the instruments above are the ancient surgical instruments used in Egypt
Innovations
