Jesudian Gnanaraj

• MS [Gen], MCh [Urology] FICS FIAGES FARSI
• Project Manager at University of Leeds

The Laptop Cystoscope is a plug and play device costing one twentieth of the investment needed for conventional cystoscopy

The article talks about how empowering rural surgeons using the Proctorship program has very significant impact on the surgical coverage in rural areas and describes the low cost methods for it

The article is about sterilization of laparoscopic surgical instruments in rural areas and new suggested methods

Laparoscopic surgery offers significant benefits to patients in low-resource settings compared to open surgery such as faster recovery, less pain and lower infection rate. However, there exist significant barriers to the safe introduction of laparoscopy such as high costs and limited availability of trained staff. LMIC hospitals suffer from higher...

Aim Virtual-reality (VR) and augmented-reality (AR) training workshops were undertaken in New Delhi and new surgical training content generated. This study aimed to gauge the perspective of medical students and rural Indian surgeons regarding VR and AR training. Method An online survey was administered to both workshop participants and rural surge...

Background Task-sharing of spinal anaesthesia care by non-specialist graduate physicians, termed medical officers (MOs), is commonly practised in rural Indian healthcare facilities to mitigate workforce constraints. We sought to assess whether spinal anaesthesia failure rates of MOs were non-inferior to those of consultant anaesthesiologists (CA) f...

The article is about frugal innovations in techniques and training for rural surgeons to learn Minimally Invasive Surgeries

Objective The Global IDEAL Sub-Framework Study aimed to combine the intended effects of the 2009/2019 IDEAL (Idea, Development, Exploration, Assessment, Long-term study) Framework recommendations on evaluating surgical innovation with the vision outlined by the 2015 Lancet Commission on Global Surgery to provide recommendations for evaluating surgi...

How is robotic-assisted surgery being developed and implemented in low- and middle-income countries, and what challenges do we face?

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, att...

VRiMS videos make the surgeons be virtually present in the Operating Rooms at the best possible position using the VR headset and also listen to learning materials and discussions from the surgeon. This made surgeons in Kabale in Uganda start Gas Insufflation Less Laparoscopic Surgeries. They are surgeons who have not had any prior training in lapa...

Background A program of gasless laparoscopy (GL) has been implemented in rural North-East India. To facilitate safe adoption, participating rural surgeons underwent rigorous training prior to independent clinical practice. An online registry was established to capture clinical data on safety and efficacy and to evaluate initial learning curves for...

Improving access to surgical care in India requires policy-level prioritization of surgical, obstetric, trauma, and anesthesia (SOTA) care. We quantified SOTA care prioritization in the last seven decades by analyzing India’s national policy and programmatic documents. Forty documents of national importance over seven decades (1946–2017) were scree...

South Asia is a demographically crucial, economically aspiring, and socio-culturally diverse region in the world. The region contributes to a large burden of surgically-treatable disease conditions. A large number of people in South Asia cannot access safe and affordable surgical, obstetric, trauma, and anesthesia (SOTA) care when in need. Yet, att...

Background Surgical site infections (SSIs) affect around a third of patients undergoing surgeries worldwide, annually. It is heterogeneously distributed with a higher burden in low and middle-income countries. Although rural and semi-urban hospitals cater to 60–70% of the Indian population, scarce data regarding SSI rates are available from such ho...

Introduction Evidence has shown a trend towards rising mortality from surgical abdominal conditions with increasing distance from hospitals in Eastern India. It has been claimed that imaging modalities such as portable ultrasound are ideal for use in rural areas of developing countries for diagnosis and management of a variety of acute abdominal co...

The article is about starting Gas Insufflation Less Laparoscopic Surgeries in Africa

The article is about using Virtual Reality in Medicine and Surgery for training rural doctors in Urology

Surgical training using technology

Laparoscopic surgery, a minimally invasive technique to treat abdominal conditions, has been shown to produce equivalent safety and efficacy with quicker return to normal function compared to open surgery. As such, it is widely accepted as a cost-effective alternative to open surgery for many abdominal conditions. However, access to laparoscopic su...

Introduction, steps and pitfalls for Gas Insufflation-Less Laparoscopic surgery -

Introduction Many surgeons, anaesthetists, and obstetricians in low and middle-income countries (LMICs) lack access to training opportunities. The purpose of this study was to evaluate the feasibility of VR procedural training at scale for these specialties. Methods An online, free to participant, single-day event programme was designed to cover o...

Introduction Gasless insufflation-less laparoscopic surgery (GILLS) was introduced in rural northeast India as part of the NIHR Global Health Research Group - Surgical Technologies (GHRG-ST) project. The GILLS Registry aims to provide a reliable mechanism for monitoring the safe implementation of the GILLS technique in everyday clinical practice by...

The article is about the Frugal Innovation and participatory method of producing the RAIS device for Gas Insufflation Less Laparoscopic surgeries

Medical equipment that can be manufactured at low cost and easily maintained will help extend surgery to the five billion people worldwide who currently cannot get access to it, say researchers. Writing in the IEEE Journal of Translational Engineering in Health and Medicine, they argue that surgical technology is often developed for well-resourced...

Background: Over 5 billion people worldwide have no access to surgery worldwide, typically in low-resource settings, despite it being a primary life-saving treatment. Gas Insufflation-Less Laparoscopic Surgery (GILLS) can address this inequity, by improving current GILLS instrumentation to modern surgical standards. Objective: to develop and tra...

Background: Surgical site infections (SSIs) affect around a third of patients undergoing surgeries worldwide, annually. It is heterogeneously distributed with a higher burden in low and middle-income countries. Although rural and semi-urban hospitals cater to 60-70% of the Indian population, scarce data regarding SSI rates are available from such h...

Background In high-income countries, laparoscopic surgery is the preferred approach for many abdominal conditions. Conventional laparoscopy is a complex intervention that is challenging to adopt and implement in low resource settings. This systematic review and meta-analysis evaluate the clinical effectiveness of gasless laparoscopy compared to con...

The group has developed an innovative device to lift the abdominal cavity and create an operating space, instead of using expensive carbon dioxide gas which is often difficult to obtain in rural areas. The technique also significantly reduces the number of disposable surgical instruments required for routine surgery and therefore limits waste.

This article explains the several ways of empowering the surgeons working in rural and remote areas and the impact of such empowerment

Introduction Laparoscopic training is restricted in low resource settings due to limited access to specialist training equipment and financial constraints. This study aimed to evaluate simulation skills and usability of an original low-cost laparoscopic trainer, the “Lap-Pack,” developed at the University of Leeds, UK. Methods Stage I evaluation w...

BACKGROUND Benefits of laparoscopic surgery are well recognised but uptake in rural settings of low- and middle-income countries is limited due to implementation barriers. Gasless laparoscopy has been proposed as an alternative but requires a trained rural surgical workforce to upscale. This study evaluates a feasibility of implementing a structure...

Background Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low...

Introduction Resource-deprived low-and-middle-income countries (LMICs) can benefit from the reduced perioperative morbidity of laparoscopic surgery. However, utilisation is low, partly due to paucity of appropriately trained staff. This study aims to explore the barriers to the training of healthcare professionals in laparoscopic techniques in LMIC...

Laparoscopic surgery has the potential to improve care in resource-deprived low-and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using 'LMIC', 'Laparoscopy' and 'Training'. Two researchers screened results with m...

Background Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income co...

Introduction Most people living in low- and middle-income countries have no access to surgical care. Equipping under-resourced health care contexts with appropriate surgical equipment is thus critical. “Global” technologies must be designed specifically for these contexts. But while models, approaches and methods have been developed for the design...

This article is about Gas Insufflation Less Laparoscopic Surgeries in rural areas.

The COVID 19 Pandemic with the suddenly announced lockdown in India caused great stress to the already resource constrained rural mission hospitals. Frugal innovations helped some of the mission hospitals cope with the lockdown and resume regular work. Personal Protective Equipment were made locally, and staff were trained to take care of the infec...

Corona virus 19 [COVID 19] is a global pandemic and has brought in severe restrictions on travel 1 in India and other countries. The Indian Government has also issued advisory for postponing non – essential or elective surgeries 2. This essentially means that surgeons, especially those working in rural areas, do have lot of time at hand. It is a go...

By this article, we get a common fixed point for the pair of set-valued maps on a G-complete G-metric spaces in new way. Further, we extend this technique and proved the existence of the coincidence points for a pair of set-valued and single-valued maps on such spaces.

Introduction Laparoscopic surgery has advantages for treating many abdominal surgical conditions, but its use in low and middle-income countries (LMICs) is limited by many factors, including a lack of training opportunities. The aim of this study was to explore the training experiences of surgeons in rural north-east India to highlight the barriers...

Composite materials have gained their presence in several industrial sectors. New materials, advanced material treatments and manufacturing methods have been introduced in research and developments today. Experimentation in composite materials has changed the people to come up with new innovations and alternative ideas in day today applications. Th...

Laparoscopic surgery has advantages over open surgery for several abdominal conditions due to improved short-term outcomes. Performing laparoscopic surgery in many low and middle-income country (LMIC) settings is restricted by the lack of general anesthesia (GA) and carbon dioxide (CO2) insufflation. Gasless laparoscopic surgery employs the use of...

This is part of the series of lectures on Rural Urology conducted by the International Federation of Rural Surgeons and is on Ultra low-cost cystoscope

This is part of the series of zoom lectures on Gas Insufflation Less Laparoscopic Surgeries arranged by International Federation of Rural Surgeons and Association of Rural Surgeons of India

This is the text of the talk given during the Viking Surgeons Webinar organized by the Royal College of Surgeons of Edinburough

This is an article about how the surgeons in rural areas used zoom meeting to treat the patients

This is part of the series of lectures on Gas Insufflation Less Laparoscopic Surgeries by International Federation of Rural Surgeons. This lecture is presented by Daniel Robertson from Delft Universtity

This is part of the series of zoom lectures by International Federation of Rural Surgeons on Rural Urology

Aim: Previous research has led to the development of an affordable, dual-continuum gastroscope for deployment in low/middle-income countries. The device couples a disposable parallel bellows actuator tip with a reusable multi-backbone 'snake-like' handle. Although comparably low-cost and intuitive to operate, fabrication of the current handle desig...

This part of the series of lectures for Rural Surgeons organized by International Federation of Rural Surgeons

This is the recommendation for doing Gas Insufflation Less Laparoscopic Surgeries (GILLS) during and after Pandemic because of the advantages it offers

This is part of the series of lectures on Rural Urology by International Federation of Rural Surgeons and Association of Rural Surgeons of India using zoom to benefit rural surgeons

Background Minimal access surgery [MAS] is not available to most people in the rural areas of Low Middle-Income Countries [LMIC]. This leads to an increase in the morbidity and the economic loss to the poor and the marginalized. The Gasless laparoscopic surgeries [GAL] are possible in rural areas as they could be carried out under spinal-anaesthesi...

This is part of the series on Rural Urology by the International Federation of Rural Surgeons and Association of rural surgeons of India

This is part of the zoom lecture on Rural Urology by International Federation of Rural Surgeons and broadcast by LapGuru

This is the first part of the series of lectures on Gas Insufflation Less Laparoscopic Surgeries during the lock - down period for the rural surgeons

Innovation ecosystems and emerging technologies can potentially accelerate the access to safe, affordable surgical care in low-resource settings. There is a need to develop localised innovation ecosystems that can establish an initial culture and catalyse the creation, adoption and diffusion of innovation. The surgathon model outlines one approach...

It is an article about experience with Gas Insufflation Less Laparoscopic Surgeries which is ideal for Rural Areas

The article describes the various models for rural surgical care highlighting the one at Shanthi Bhavan Medial Center Biru

It is about the Rural Surgery Training and research center started at Shanthi Bhavan Medical Center at Biru by the Association of Rural Surgeons of India and International Federation of Rural Surgeons

It is a cancer screening device with artificial intelligence

The present invention disclose an unique, easy to handle, patient comfortable, better accessible Specnoscope for examination of cervix and Vagina to diagnose cervical lesions with clear field of examination and analysis of cervix and vagina. It is an objective of the present invention is to overcome the disadvantages of the specula that are present...

The Gas Insufflation Less Laparoscopic Surgeries [GILLS] was an innovation that was promoted by ARSI. The ARSI presented the Antia Finseth award [1]. Recently the GILLS was included by the World Health Organization in the Compendium of Health Care technology for low resource setting [2]. GILLS has many advantages. It is possible under the easily av...

The article is about diagnostic camp in a very remote area of Arunachal pradesh in India requiring two days drive and one day walk to reach the place

The Gas Insufflation Less Laparoscopic Surgeries [GILLS] are a great boon to the Rural Surgeons for many reasons. It is possible under the easily available Spinal Anesthesia. It is relatively easier to learn. It is less expensive and offers advanced procedures like Single Incision Laparoscopic Surgeries to the poor and the marginalized. In addition...

Background Effective dissemination of technology in global surgery is vital to realize universal health coverage by 2030. Challenges include a lack of human resource, infrastructure and finance. Understanding these challenges, and exploring opportunities and solutions to overcome them, are essential to improve global surgical care. Methods This re...

Traditional Cystoscope requires a telescope, the sheath, and a light source and if procedures are carried out without directly looking into the scope a camera and monitor to display the pictures. Our innovation is a cystoscope that does not have a telescope and connects directly to a Laptop, Desktop, Android devices and mobile phones.

This case series of 51 patients (age range = 11–17 years; 30-month follow-up) describes a new modified approach to treatment of distal and mid-penile hypospadias that has fewer complications. The meatal locations were sub-coronal (51%), coronal (45%) and mid-penile (4%). Forty patients had chordee. Urethra with the corpus spongiosum was dissected o...

Diagnostic laparoscopies are a very useful diagnostic tool especially in rural areas. However, the very high costs of the current diagnostic equipment make them unavailable to most of the rural centres. We describe a low-cost laparoscope that does away with the telescope and rod lens system and offers very good quality pictures for diagnostic lapar...

Medical Images are often used for diagnosis of a variety of disease process. The findings noted on the images depend on the type of process that is used for obtaining the images. For example the images provided by CT scan and MRI are different. Combining these images might give better understanding of the disease process. Nuclear imaging modalities...

In India cervical cancer contributes to 6 to 29% of all cancers in women and has an incidence of about 20 per 100,000 population [1]. The pooled estimates of sensitivity and specificity of visual inspection with acetic acid (VIA), magnified VIA, visual inspection with Lugol's iodine (VILI) is 67.65% and 84.32%, 65.36% and 85.76%, 78.27% and 87.10%...

Anesthesia is an important consideration in rural areas because of the higher costs and lack of availability. It is a logistic nightmare to get bottled gases and experienced anesthesiologists in rural areas. We look at the various types of anesthesia used for laparoscopic surgeries in rural areas.

This article is a proposal to start Gas Insufflation Less Laparoscopic surgeries and Rural Urology training programs in Uganda with the help of Association of Rural Surgeons of India