New Delhi: Jaipur-based surgeon Atul Kumar’s patented invented device could potentially reduce the risk involved in endoscopic surgeries - a minimally invasive surgery employed to operate such vital organs as the brain, spine and uterus. It also appears to have the potential to help doctors decide whether to go in for a hysterectomy, or uterus-removal surgery, which many gynaecologists say account for the bulk of operations on women in India.
The invention, if and when it becomes an accepted and approved device in medical procedures, could enable even relatively inexperienced surgeons to perform complex endoscopic surgeries.
Dr Kumar has obtained a patent in India for the device and has patent applications pending in the US and UK.
His invention attempts to replace human judgement with a machine that calibrates the pressure of the liquid - a water and glycine solution used - in such surgery - which enables doctors to pry apart the body tissues and perform the surgery.
Too much pressure would mean greater quantities of the liquid and could potentially prove fatal if its concentration exceeds acceptable limits in the blood stream. Too little would mean that the tissues are not pried sufficiently apart for doctors to get a better view of the area being operated upon.
Dr Kumar’s invention manages to maintain this pressure at an optimum level. “The device continually monitors the pressure levels, and gives a markedly clear view of the area being operated upon. Thus, the surgeon can concentrate more on the surgery, rather than worrying about pressure levels,” Dr Kumar said.
Dr Kumar, 46, never really wanted to be a doctor.
“I wanted to be an electronics engineer, but my father - a cardiac surgeon—insisted that I take up the medical profession,” says the surgeon, who nevertheless kept himself updated on his pet subjects, mathematics and physics.
Dr Kumar’s device in some ways is an ingenious embodiment of certain principles of fluid dynamics.
Dr Kumar, who is a specialist in hysterectomy, says he spent about Rs50 lakh over a three to four year period on developing a prototype of the device. Some Rs5 lakh of that came from a grant given by the Department of Scientific and Industrial Research, which is part of the ministry of science and technology.
Dr Kumar says he has buyers interested in producing the device. “All I can say now is, I have licensed the apparatus to medical companies in the US, but contracts with the company prevent me from mentioning their names,” he said.
Similar systems, which are primarily German- and US-made, cost about Rs2-3 lakh. Dr Kumar says that his device hasn’t been commercialized yet, which makes it hard to arrive at a possible per-unit price.
Dr Kumar made the device in his own lab, using outsourced tubes and controllers. Senior ministry officials have also seen a demonstration of the device. Dr Kumar says his device might be “5-7% costlier”, though the actual price can be determined only after the product is commercially manufactured. “However I am banking on its innovativeness for it to be popular,” he added.
Current systems, such as the Dolphin Fluid Management System, for instance, also don’t allow real-time monitoring of the pressure.
News of the device comes amid a larger debate, especially in India, about whether there is really a need for many of the hysterectomies that are conducted.
A host of leading surgeons also believe that a good number of hysterectomies are unnecessary. “You don’t need that all the time,” said Niraj Pathak, a professor of obstetrics at the Postgraduate Institute of Medical Education and Research at Chandigarh. “It’s like cutting out an arm to treat an itch.”
Experts believe that often doctors opt for hysterectomy, because they are unable to get a perfect view of the affected part, and would prefer to err on the side of caution.
Dr Dr Kumar contends that the better visibility, which his apparatus provides, encourages surgeons to avoid hysterectomy, as much as possible.
Dr Kumar doesn’t yet have a name for the device. “But you can refer to it as the Kumar Fluid Distending System,” suggests Alka Kumar, his gynaecologist wife and a collaborator in the invention.