Frugal Innovations in Surgical Training

Three surprising common household items that can be used to teach surgical skills in low resource settings

Not just any papaya will do. It’s the salmon-red to pink flesh of the strawberry papaya that closely mimics the anatomy of a woman’s uterus. This tropical fruit is commonly used to train clinicians and health officers how to perform intrauterine procedures, such as insertion of IUDs. Although the so-called “papaya model” is also taught at world-renowned medical universities in the United States, it is one of the most common examples of teaching surgical procedures in low-resource settings.

“Teaching surgical skills can be expensive, and traditional models can be complicated,” says Sherry Wren, M.D., Professor of Surgery at Stanford University, member of the leadership team for Stanford’s Center for Innovation in Global Health, and founder of the innovative International Humanitarian Surgical Skills Course. “The use of cadavers is a challenge in low resource countries, and while virtual reality is an exciting field, it can be very expensive.”

The Global Surgical Training Challenge, a collaboration among Intuitive Foundation, Nesta Challenges and MIT Solve seeks to address this gap. The Challenge is a contest designed to find innovative ways to develop lower cost, validated, simulation-based surgical training. The global challenge calls on innovators to develop surgical training modules that can be used in low-resource settings to help teach practitioners surgical procedures and techniques.

“One of the most common causes of maternal death in the global south is postpartum bleeding,” says Dr. Wren. “Using a common car washing mitt, we can teach clinicians to perform a B-lynch procedure that can stop the bleeding and save lives.”

“We know there are certain skills that people need, and we need to come up with lower cost alternatives for teaching them.”

Sherry Wren, M.D

Professor of Surgery at Stanford University

These are examples of the kinds of inexpensive, reproducible and frugal innovations that can make a significant impact in areas where few training resources are available. They are also the kinds of training models that the Challenge seeks to support.The Challenge is open to surgical practitioners, clinicians, medical educators, technologists, engineers, designers, artists, and other creatives. Teams or individuals are encouraged to participate in a series of interactive, and virtual Solveathon workshops, hosted by MIT Solve.

In farming communities, hand injuries are common. Two inexpensive dental rolls, the tight cotton wads used by dentists, laid end-to-end on a table can simulate the cut ends of a tendon. Surgeons can use this simulation model to practice tendon repair sutures. Likewise, pig trotters can be used to practice flexor tendon repair.

“Surgeons need these skills. This is the opportunity with this Challenge, “ says Dr. Wren. “We know there are certain skills that people need, and we need to come up with lower cost alternatives for teaching them.”

Teams and individuals who are interested in participating in the Challenge can sign up for a virtual Solveathon workshop in their region by going to the Challenge website.