Hackascope
Low Resource Endoscopic Banding Device for Esophageal Varices
in collaboration with Dr. philip levine, dr. paul hausknecht, vaidehi thanawala, suganya karunakaran, Anuj Marathe Dr. Sharmila Anandasabapathy
Problem Statement
An alarmingly high percentage of the population of West Africa, especially Gambia, suffers from Hepatitis B and end stage liver disease which often leads to gastrointestinal bleeding. The bleeding is due to the rupturing of esophageal varices, which are abnormally enlarged veins that develop when normal blood flow to the liver is blocked due to a clot or scar tissue.
Endoscopes can be used to perform band ligation which wraps elastic bands around the varices so that they cannot bleed and so that flow is diverted due to increased resistance. Current endoscopic care is too expensive, complex, and inaccessible for low resource settings. Endoscopes cost up to $60,000 and still cost $10,000 on the lower-end.
A low-cost solution is required to perform the same functions as the endoscopes commonly used in high-resource settings, such as finding veins and providing suction to the varices. Considerations in designing the solution include limited access to electricity, lack of technical knowledge by medical practitioners, and a need for portability.
Work Done and Proposed Solution
Taking place at the Baylor College of Medicine Global Health Hackathon, the ideation behind the final prototype started with a market analysis of the medical technology landscape of Gambia. Further research looked at the different technologies incorporated into endoscopic care in high-resource settings and existing products in low-resource settings.
Initial designs and prototyping started with high-level drawings of various design elements (Figure 1) and a CAD model of an adapter (Figure 2) necessary to assemble the elements together. The adapter includes a port for the endoscopic camera and light, a port for the vacuum suction, a port for elastic band deployment, and a port for guide wires for movement.
Figure 1. High-level drawing of various design elements involved in an endoscopic banding device
Figure 2. CAD model of an adapter necessary to assemble all design elements involved in an endoscopic banding device
Rapid prototyping began after a trip to a local electronics store (Figure 3) in which various materials were purchased:
Figure 3. Hackascope team reviewing part orders from a local electronics store
- 5 mm USB endoscopic camera
- Guitar strings
- Thin medical tubing
- Medical syringe
- Heat shrink wrap
The final prototype of the Hackascope (Figure 4) used the 5 mm USB endoscopic camera which included a light for finding veins when connected to a laptop or smartphone. The guitar strings were used as guide wires to control the movement of the device. The medical tubing was used house the guitar strings in a flexible but durable space to ensure easy movement. The medical syringe, connected to the medical tubing, was used to create the vacuum for suction of the varices. The banding mechanism, consisting of disposable elastic bands and a disposable banding ring, was removed from an existing banding device. The adapter put all of the parts together via its ports and the heat shrink wrap was placed around the entire device to allow for the entire device to be sterilized.
Figure 4. The final prototype of the Hackascope, an endoscopic banding device for esophageal varices
The Hackascope costs only $60 in parts, which is only 1% of cost of a high-end endoscope for the same function. In its function, the endoscopic camera provided 3MP optics which were enough to detect varices, the medical syringe provided enough negative pressure to vacuum and hold onto varices, and the guitar strings allowed for multiaxial movement. The device is also portable and accessible in its size and its ability to connect to laptop or smartphone. Made from various everyday parts and a simple assembly, the device is easy to repair and use and is adapted for areas with irregular electrical access.
Outcome and Future Work
The Hackascope is a viable alternative for endoscopic procedures and has further diagnostic and therapeutic potential in the gastrointestinal field. The process of designing the device has led to our questioning of traditional medical systems and emphasis on patient-centered design and DIY medical technologies.
Figure 5. The Hackascope team with their award for placing 1st at the Baylor College of Medicine Global Health Hackathon
The device was demonstrated effectively at the Baylor College of Medicine Global Health Hackathon in video above and placed 1st in the competition (Figure 5).
The project has thus been passed onto Baylor College of Medicine to further development. Areas of future work include prototype refinement and design for manufacturing, partnership development with international and local healthcare organizations, and the training of healthcare providers to use the device.
Awards
Baylor College of Medicine Global Health Hackathon 1st Place (2015)
Press
Hacking for a Cure by Britni Riley (TMC News)
Global Health Hackathon encourages collaboration, innovation by BCM Office of Communications (Baylor College of Medicine)
Baylor GI Fellows Earn First Place at Baylor Global Health Hackathon by Section of Gastroenterology and Hepatology (Baylor College of Medicine)