Monday, September 24, 2012

Keep It Simple, Surgeons



Frequently, when we talk about innovation, the images that spring to mind are advanced technology, sophisticated and cutting edge approaches, like robotic surgery, image fusion, and on and on. Recently, though, the institute hosted a special innovation rounds with nationally known pediatric surgeon Michael Gauderer, MD, who has been a pioneer in another type of innovation: simplicity.

Dr. Gauderer outlined some of his most successful work to find solutions for surgical challenges, and each example focused on finding the simplest procedure or device to safely address the problem in question.

He gave one example that involved the alteration of a typical surgical needle to aspirate an abscess, or drain a child’s boil. Typically, the person draining the boil has to hold the squirming child with one hand, and manage to insert a long needle to a specific desired depth freehand with the remaining hand—challenging to do with no guide. This increases the risk that the caregiver could stick someone accidentally with the needle, and also, if the needle goes too deep, there is the risk of injury to underlying structures like blood vessels or nerves. Dr. Gauderer altered the existing cap of the needle by removing the plastic cap of the needle, cutting that cap, and then slipping it back over the needle. The level of the cut across the cap pre-determines the depth of penetration of the needle. This holds the needle stable and enables it to be quickly inserted at exactly the right depth with one hand.

The beauty of this idea, says Dr. Gauderer, is that most of the time, it doesn’t require applying for grants, protected research time, or specialized tools. Instead, looking at the existing environment as a resource for new and interesting approaches can be a path to safe,effective, inexpensive, and practical answers to pressing problems.

In his experience, this “simplicity in surgery” can often find solutions that are as elegant as complex ones, and often more readily available. So, his best advice to aspiring innovators, is really, whenever possible, to follow the KISS principle.

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