GMI Student Perspectives | Erik Wu: Mid Semester Report

Reflections from Global Medical Innovation MBE students.

Ellie Reynolds in lab.

These past couple of months have gone by so fast. From the blistering hot days of August to the only sometimes blistering hot days of October, it feels like almost no time has passed since coming back. However, since my last post, a lot of work has been done, from scoping a problem with my healthcare innovation and entrepreneurship team to talking to stakeholders and moving forward with the global project. Now back from Costa Rica for about 3 months, things are finally in full swing, as I navigate the deadlines and the deliverables for my year long projects.

The first project I am working on is developing a low cost laparoscopic trainer that can be used to teach basic skills in a variety of different contexts. Communicating with Dr. Salas at Baylor College of Medicine in Houston, Dr. María Calvo Castro at UCIMED in San Jose, Costa Rica, and Dr. Luis Romagnolo at IRCAD in Barretos, Brazil, Eddie Yao, Ellie Reynolds, Dr. Rocky Browder, and I were able to have many productive and informative conversations on what such a device would entail, and how existing models could be improved. Specifically in the United States, there is currently a training curriculum that general surgeon residents take which help them learn how to conduct basic laparoscopic procedures such as cutting and suturing. However in other countries like Brazil and Costa Rica, there are limited opportunities for residents to receive this training due to the prohibitive cost of the testing equipment and the lack of standardized equipment. With current models starting at $4,000 and up, there exists a market for regional hospitals and training facilities to invest in equipment that can adequately train surgeons for laparoscopic procedures. Considering that laparoscopic surgery is preferred in most cases due to less scars and fast healing in patients, this skill is invaluable to learn for medical professionals in the field worldwide.

There are also benefits in the US as well; Dr. Salas mentioned that he wanted medical students at BCM to also have opportunities to practice laparoscopic surgery techniques on their own time so they would have more experience before residency. Rather than solely relying on expensive virtual reality simulations, these types of students can use a lower tech solution get the feel of how laparoscopic surgery can be done before choosing a specialty. Additionally, by working with the Baylor Simulation Lab, our team was able to actually try out some of the skills tested in laparoscopic surgery using the facilities. Observing first hand how difficult it is to move pegs around or cut a preordained pattern, we were definitely able to see why a low cost laparoscopic trainer can greatly improve surgical outcomes worldwide. After all there is a reason why in the United States laparoscopic surgeons undergo a training period before taking a standardized test. We are currently about to move into preliminary brainstorming and prototyping after better understanding the needs associated with this problem. Hopefully if all goes well we will even be able to present our work at SAGES 2020 conference in Cleveland, Ohio (which if you ask a certain Aedan Mangan is the best place in the US, if not the world).

On the second project, after observing many operations in Pediatric Gynecology with Dr. Julie Hakim and procedures in Urology with Dr. Chester Koh in Texas Children’s Hospital, we have finally been able to figure out what would be the best local medical need to solve. Currently in laparoscopic and more specifically robotic procedures, it is difficult to keep the bowel and the intestines out of the way during an operation. In fact, using the current tools like the graspers to hold the bowel can actually lead to increased risk of perforation and damage to the area. During open procedures, it is super easy to hold organs back; in fact, some operating tables even come with attachments that can accomplish this task. However laparoscopically, it is much more challenging due to size and space restrictions. Therefore, a tool that can be inserted through a port and retract would be of great use. While laparoscopic bowel retractors do exist, many designs are currently not widely implemented since they are either the wrong size or have other complications (ie. a retractor that opens up like a fan can obscure the field of view or even damage the organs itself). Furthermore, since Texas Children’s works with pediatric populations, there is a lot that can be done for this population specifically. Since we are not as far along on this project compared to the other one, team UroGyn (consisting of Lamiya Sakarwala, Ross Clark, Sydney Sheffield, Luke Parkitny, and myself) will begin the user needs and inputs definition stage of the design progress.

On an unrelated note, opportunities from this project also allowed me to be able to shadow a wide variety of operations and procedures in specialties I had never seen before. As someone who is interested in both practicing medicine and serving patients specifically as well as working to improve the quality of care on a larger scale, it was informative to see one way this can be done. Through the expertise and knowledge that comes with a medical degree, physicians are not only best equipped to identify different areas of improvement, they are also able to better understand what can and cannot work within the existing workflow. I aspire to be able to emulate this with my career to improve how healthcare is administered.

In addition to all the project work, I have somehow found time to visit the Texas sites and plan a variety of events with the rest of the GMI’ers. From visiting the Alamo and organizing a board game night over Rice fall break, to watching countless baseball and soccer (English Premier League) games as a cohort and others it’s been great to get to know these people (especially the ones who did not go to Costa Rica) more outside of the team project context. I couldn’t have found a better cohort to spend the year with.

*This is a joke; it still blows my mind how tiny the building is every time I visit.

Erik Wu, 2019-20 Cohort, MBE in Global Medical Innovation