design research russia. medical equipment

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Universal Surgical Complex for Different Types of Invasive Operations and Endoscopy.

Case sudy of Russian Design Research


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Name of Research ProjectUniversal Surgical Complex for Conducting Different Types of Invasive Operations and Endoscopy

Name of Lead ResearcherVyacheslav Bondarev

InstitutionLumiknows

ClientsOptimed, Efa - at the time of the project (2004), the largest in Russia makers of invasive surgery equipment who decided to join their efforts to design a universal surgical complex.

Research Aims and context:There are different types of invasive operations and endoscopy. It depends on the particular target organ, and also varies between different hospitals and even within surgical crews. Each type has its own peculiarities in the ways the surgery is performed, but also in the methods and consecution of actions surgeons are used to following.

The key research aim was to develop a universal multifunctional complex allowing conducting different types of invasive operations and endoscopy in any Russian hospital by any surgical crew. Another challenge of the project was that the complex, at the time consisting of several modules, should have been compatible with modules being produced by various certified makers of medical equipment – both Russian and foreign.

Research activities and methods:The project was divided into three phases: design research resulted into design brief, development phase and creating a pre-production model.

The focus of the research was on the analysis of different types of surgical processes and the surgeon’s workplace. The phase has become a combination of the two approaches: a four-week video ethnographic observation in several St.-Petersburg hospitals (p.1) with a following processes-orientated value analysis (p.2). At the core, a holistic approach to the complex under development lied: the complex was approached as a part of the larger system – an environment and, at the same time, as a container for smaller systems (control interfaces, communications between devices etc.). Such methodology allowed identifying problem issues concerning the structure of the complex, antagonistic relationships between the complex parts and even rules for the further evolution of similar sophisticated medical equipment.

Research Outcomes:The research phase has resulted into two design concepts. The first one was realized and is now serially produced in two modifications: by Optimed for hospitals and by Efa for air-mobile hospitals deployed by the Russian Ministry of Emergency Situations.

The complex designed has allowed to solve the following critical for such operations issues: optimize the surgeon’s workplace which resulted in the preventing possible errors; make the process of preparing the complex to work and control during the surgery much easier; reduce the duration of the surgery which, in turn, decreases negative impact on patient of being under a long anesthesia; reduce the number of medical staff who were in charge of adjusting the complex during the operation (usually, one-two people) which reduces the costs of operations and medical treatment as a whole.

The other concept required serious modification of the surgical environment and, thus, changing of an established chain of suppliers including special medical furniture makers. Due to significant investment needed to accomplish the project in this way, the concept was not realized. In the meantime, some of the principles in the evolution of such complexes formulated during the project have proved its correctness in the da Vinci Surgical System.


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A. Supporting elements (post, rests, table)

Supporting elements occupy a considerable 1. amount of space near surgical table, but to move them away is impossible since, in this case:connections with devices are getting longer;• reading of information from monitors is • worsening;Supporting elements accumulate dust, 2. especially its horisontal surfaces which is a problem for a surgical environment;To adjust the surgical table during the 3. operation an additional person is needed (image 1).

B. Connections (wires, hoses, light pipe)A large length of connections (from 2 to 1. 2,8m) results in considerable losses of information;Connections are a problem since on its 2. way they sag, touch the floor, become unsterilized, are pressed down by the personnel which, all in all, may cause an emergency situation (image 2);Connections create a 'dead zone' near 3. surgical table not allowing an access to patient from the complex's side;Connections block reading information and 4. devices control;Connections require considerable amount of 5. time to connect up and disconnect before, during and after the operation (image 3).

C. Apparatus (monitor, devices)To adjust devices during the operation, an 1. additional person is needed (image 4);Due to the lack of space between surgical 2. table and devices, access to adjusting devices is difficult;It is almost impossible to read information 3. from the modules locating in the lower part of the complex;Lack of flexibility in the monitor location 4. results in inconvenience of following critical information from monitor during the operation (image 5).

D. ToolsSince TV camera and its wire are not 1. sterilized, they require a sterile case with a lenght of 1 m which makes connecting up of laporoscope and adjusting the camera's sharpness difficult (image 6).Light pipe is connecting up to laporoscope 2. under an inconvenient 90 degree angle (image 7).

The main findings of the observation phase resulted in identifying the four problem areas: (1) Supporting elements, (2) Connections, (3) Apparatus, (4) Tools:

2 3

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4 5

1


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F1F2F6 F5 F4 F3F7

8

7

6

5

4

3

21

910

I. Initial Situation

II. Analysis of Operational Zone:

Surgeon1. Patient2. Surgical Table3. Tools4. Connections5. Modules6. Monitor7. Control Panels8. Supporting Elements9. Additional Equipment10.

III. The Priority of Tasks

The main task of the complex is to receive and trasmit full informationato make a decision.

Rating in accordance with the main task:

F1. The Operation Information F2. The Tool of Performing the DecisionsF3. The Devices InformationF4. Modules to Maintain the Devices WorkF5. Connections to Transfer Materials and Energy to DevicesF6. Supporting ElementsF7. Others

IV. Desirable Outcome

Processes-orientated value analysis:

II. Analysis of operationa zone

III. The Priority of Tasks


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950

Bulky Equipment

'Dead Zone'

Connections Zone

Convenience of Observing

Convenienceof Control

Initial Sitution (1)

Realized Concept (2)

Advanced Concept (3)

Problem Issues

abs

Remote Control Remote Control

Research Outcomes in a Form of Comparative Analysis of Problem Issues in All Three Modifications of the Complex:


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Initial Complex

Serially Produced Complex since 2006


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