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LOW COST INSTRUMENTS FOR VATS IN ASIAN SETUP
Ali Zamir Khan, Shaiwal Khandelwal, Narendra Agarwal, Kamran Ali.
Medanta, The Medicity, Gurgaon, India.

Objective:
To highlight the need for innovation to develop indigenous instruments specifically designed for Asian diseases like tuberculosis to help set up a low cost VATS program in the third world.
To share our design with the thoracic community
Methods:
Instrument are designed and constructed according to the needs of local disease like tuberculosis and aspergilloma. Auto CAD software is used to finalize design. A local manufacturer with a Lathe machine is used to create prototypes. Instruments are tested in animal wet laboratories and subsequently in real surgery. A mould is prepared to manufacture on a larger scale. Cost is tabulated and calculated carefully.
Results:
Use of local materials and manufacturers reduces cost in terms of materials and import duties. Cost of labour is cheaper in Asian setup. Metallic instruments for reuse are cost effective. Practice of endoscopic suturing and ties also decreases the need for costly disposable staplers. We have managed to keep cost down to under \/- for a set of 10 VATS instruments.
Conclusion: In Asian countries innovation is the key to reduce cost. Use of a local manufacturer and materials reduces cost. Setting up a facility for trialing instruments in a Wetlab gives correctional ideas.


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