C2I 2022: Medical & Healthcare shortlist

Project: The RAIS device for global surgery

Leeds University with Maulana Azad Medical College, India; Ortho Life Systems, India, Pd-m International Ltd, UK; Association of Rural Surgeons of India and International Federation of Rural Surgeons, India; and Operating Theatre Practitioners Association of Kenya (OTPAK)

Surgery could be extended to billions of people with medical equipment that is manufactured at low cost, is simple to use and easily maintained. That is the aim of RAIS (Retractor for Abdominal Insufflation-less Surgery), an international, multiple disciplinary collaboration led by Leeds University.

Surgical technology - often developed for well-resourced healthcare systems - is of little or no use in poorer settings where hospitals lack support infrastructure or appropriately trained staff. 

To overcome this, the project focussed on a development approach based on participatory design, where the users of the technology are closely involved, and where functionality of the device is pared back to key essentials.

Laparoscopic surgery was identified as an intervention that lowers risk of infection and improves patient outcomes. It requires the surgeon to inflate the patient’s abdomen with CO2 to create space to see internal organs and to manipulate instruments. An alternative method – gasless laparoscopy that employs a mechanical retractor or clamp to lift the abdominal wall - failed to gain traction due challenges with using and maintaining the retractors.  

Along with surgeons and a medical device manufacturer in India, a new retractor – RAIS - was designed and proven to be fit for purpose in a low-resourced healthcare setting. 

Project: 3D Heart project

Partners: King's College London and Evelina London Children's Hospital

Virtual reality (VR) technology developed by the 3D Heart project could improve outcomes for patients who undergo surgical procedures for congenital heart disease (CHD).

In fact, over 65 per cent of paediatric patients with CHD will require surgical or catheter-based interventions during their lifetime, and their improved survival has increased clinical demand for these procedures.

An ideal cardiac procedure converts the heart back to a normal or near-normal circulation, but this can be challenging without a true understanding of 3D relationships prior to the intervention. Consequently, pre-procedure planning using detailed imaging including echocardiography, CT scans or MRI of the heart are essential.

Traditionally, the images are reviewed on 2D computer screens, which does not provide a faithful visualisation of the 3D information.

Now, the 3D Heart group has developed a VR system which displays 3D multimodality heart imaging to support procedural planning.

This collaboration allows surgeons to load, visualise and interact with this acquired visual data without requiring the assistance of an imaging specialist.

The VR environment gives the operator depth perception plus intuitive tools for interrogating the imaging, which enables the surgeon to achieve a better understanding of the 3D nature of the patient's individual anatomy.

Project: MicroRNA Sensor for Kidney Transplant Patients

Haydale Limited with Wales Kidney Research Unit (WKRU), Cardiff University School of Chemistry, Cardiff and Vale University Health Board, University Hospital of Wales

There aren’t enough kidneys available for the more than 6,000 people with chronic kidney disease (CKD) awaiting a transplant in the UK.

This shortage has led to the use of kidneys with ischaemic damage due to shortage of oxygen, which are more often rejected or fail to work straight after transplant. Kidney transplant surgeons call this delayed graft function (DGF), and tests for it usually involve a kidney biopsy that can lead to complications, or even kidney loss.

Haydale and partners from the Wales Kidney Research Unit (WKRU) at Cardiff University are seeking to redress this with an electrochemical urinary microRNA detection method that is quicker and cheaper than polymerase chain reaction (PCR) tests that are complicated, slow, expensive and not ideal for general clinical testing.

To avoid this, the team is developing a simple quantitative electrochemical urinary microRNA detection test suitable for the biochemistry laboratory and/or point of care. The aim is to develop a dipstick-style electrical microRNA sensor for rapid, reliable DGF risk detection that greatly improves on current test methods.

The collaboration combined Haydale's expertise in electrode fabrication from plasma functionalised graphene, and Wales Kidney Research Unit's microRNA analysis experience with the expertise of Dr James Redman and PDRA Dr Daniel Smith.

Project: Morecambe Bay NHS rebreathing hood

BAE Systems with University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT), The Innovation Agency (the Academic Science Network for the North West Coast), and Lancastle

Engineers from BAE Systems’ Submarines business, along with Lancaster-based company Lancastle and staff from University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) are runners up in C2I 2023 for developing the Morecambe Bay hood, a vital piece of hospital PPE that went from concept to Health and Safety Executive approval in 11-months.

The Morecambe Bay hood is a Powered Air Purifying Respirator (PAPR), a piece of kit that is expensive and can only be bought from accredited suppliers. This was problematic during the COVID pandemic as accredited suppliers were overseas, out of stock and didn’t offer products suited for use in a hospital.  

Working with the Innovation Agency - the Academic Science Network for the North West Coast - a collaboration was formed to develop the upgraded PPE, which is equipped with an innovative air manifold system with special noise reducing features, a large visor and a protective sheath which extends over the chest and back.

The full-face protective hood delivers a continuous stream of clean filtered air that reduces ‘fogging’ and aids improved communication and empathy between healthcare staff and patients because facial expressions can be seen through the visor more clearly, and lip-reading is easier.

Project: Smart Templates for prosthetic socket design - HIGHLY COMMENDED
Radii Devices, Southampton University and Opcare

NHS England’s Prosthetics Patient Survey Report 2018 found socket fit to be one of the most common complaints among prosthetic users. Furthermore, an average of nine fitting sessions are required to achieve a comfortable fit.

To make the prosthetic, a prosthetist will take a plaster cast of the residual limb, 'rectify' it (changing its shape to achieve desired load transfer pattern and avoid loading vulnerable sites) and then produce trial – then definitive - sockets. They work by hand from limited objective data, and it takes years to develop this skill.

Some prosthetists use CAD/CAM, designing the rectified socket in software from a 3D surface scan of the residual limb. This method generates anatomic and design data, but these datasets have not been used to inform clinical practice.

The collaboration between Radii Devices, Southampton University and Opcare embarked on improving objective basis of design by developing simulation methods which would let prosthetists predict and compare the performance of candidate sockets. The collaboration’s main breakthrough was identifying the potential of combining historic socket design data with 'outcome measures' (patient-reported scores of their sockets' comfort, or measures of their time to stand up or walking speed), to build an evidence base for best practice in socket design.