Jack Gardner, 1, Vincent Dusabejambo, MD2, Steve Bensen, MD3 1Dartmouth Hitchcock Medical Center, Hanover, NH; 2University of Rwanda, Kigali, Kigali, Rwanda; 3Dartmouth Hitchcock Medical Center, Norwich, VT
Introduction: The considerable expense of disposable medical devices is a primary driver of worldwide health inequity in caring for patients with gastrointestinal disease. Commercial single use endoscopic multiband ligators, used for esophageal variceal band ligation (EVL), are usually priced between $150-$350 USD. To enable greater access to EVL, we used disruptive innovation to develop a novel endoscopic multiband ligator.
Methods: We designed a prototype handle “ENDOhandle” on Fusion 360 using CAD modeling. The handle consisted of four 3D printed components – a base that holds the supporting bearing and connects to the endoscope, two supporting bearings, and a spindle. The two supporting bearings are attached via slots in the base and are pressed into place by remelting the plastic composite. The spindle is then fed through the two bearings and can be turned to facilitate the deployment of the bands (Figure). We then contracted a medical device company headquartered in Kolkata, West Bengal, India that could export a cap, trigger cord and latex bands for $4.25 per unit to the United States. By marrying the “ENDOhandle” and cap, thread and bands, a functional banding unit was created.
Results: The total cost to the hospital of the banding unit was $4.80 USD, compared to several hundred USD for commercially available devices available in the United States. Combining the novel 3D printed component with the commercially available cap, thread and bands allowed for successful band deployment in pilot trials.
Discussion: We used disruptive innovation technology to create an inexpensive and practical endoscopic multiband ligator that we hope will eventually dramatically improve EVL access to resource-challenged health settings.
Figure: The "ENDOhandle" actuator device
Disclosures:
Jack Gardner indicated no relevant financial relationships.
Vincent Dusabejambo indicated no relevant financial relationships.
Steve Bensen indicated no relevant financial relationships.
Jack Gardner, 1, Vincent Dusabejambo, MD2, Steve Bensen, MD3. P2372 - Using Disruptive Innovation to Design Endoscopic Ligators for Resource-Challenged Health Settings, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
