Our Innovations
Time and again we come up with situations in our day-to-day practice, which are difficult to manage, not only from a clinical perspective, but also due to resource limitation. This may stem up due to limited availability, the cost involved, lack of expertise or other patient related factors.
While majority of medications and devices are now available in India, cost remains a major limitation. While these devices are routinely covered under insurance in the West, that is not the case in India. At the same time, universal health insurance is far from reality.
Since most of the research happens in the West, the medical devices so conceived are customized to their population. The conditions in India are very different, the disease spectrum is very different. Hence, many a times, the standard approach may not be extrapolated to our patient category. The risk of infections in India is higher, the climatic conditions are different, the per capita income is lower, and the healthcare utilization is much lower.
These factors demand low-cost innovative solutions to tackle challenging solutions, where existing treatment options may not be suitable. Over the years, we have come up with few innovations and pushed them into the public domain. As a result, few of these have become standardized and have been adopted in the West as well.
We are happy to share some of these innovations.
The Hitch Stitch
- Airway stents are either the modality of choice or salvage therapy for central airway obstructions, both, due to malignant and benign causes.
- However, since airways are dynamic, it can lead to stent migration, which itself can present as an emergency.
- Literature has described a few techniques to hold the stent in position, but most of them require some additional prosthesis, and are expensive.
- We devised a low cost, cosmetically superior, technically simpler
An innovative solution for T tube obstruction
- Montgomery’s T tubes are required for airway stenosis, especially in patients who have a prior tracheostomy.
- However, blockage of T tube poses a challenge, especially if not cared for adequately.
- We came up with an innovative solution of using fenestrated tracheostomy tube along with a silicone stent in the proximal, subglottic airway, which in principle is like a T-tube, functions like a T-tube, however, is technically easier to deploy, and offers a low-cost solution for the patient.
EBUS Forceps Biopsy
- Many a times, we struggle with negative results from mediastinal lymph node sampling. This may be due to non-representative sampling or inadequate tissue acquisition.
- We report use of forceps trans-bronchially into the mediastinal lymph nodes, to obtain larger tissue samples for histopathology.
- This has helped redefine the algorithm for negative EBUS procedures.
Innovative solution of persistent air leaks – CESB
- Surgery is the standard therapy for persistent air leak (pneumothorax/bubbling in the ICD persistent even after 7 to 14 days).
- However, many of these patients are not ideal candidates for surgery due to poor functional status.
- Moreover, the standard available bronchoscopic modalities are expensive and sometimes not useful.
- We devised a low cost, indigenous method of dealing with this issue, which has been highly successful.
CESB for Hemoptysis
- The same CESB device was found useful for management of refractory/massive hemoptysis, when other modalities are not useful.
- This can help tide over the crisis, until a more definitive therapy such as surgery can be performed.
