WIL2910 Placement Showcase
Medical Instrument Design
With Dr Randy Bindra
Gold Coast private Hospital
Employabiltiy Modules Completed: Indigenous cultural awareness module
Professionalism module
Introduction
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Dr Randy Bindra
Professor Bindra is internationally recognised as a leader in hand and wrist injuries. He treats wrist fractures from falls, work related injuries and multiple fracture injuries from severe trauma. He also performs corrective surgery for fractures that have not healed optimally. Professor Bindra offers keyhole surgery for early arthritis and joint replacement surgery for advanced cases. He treats nerve disorders such as carpal and cubital tunnel syndrome as well as microsurgery for nerve repair and poor circulation of the hand. He has extensive experience replanting amputated digits following trauma. Professor Bindra treats a variety of childhood problems present at birth or developing with growth. He particularly enjoys restoring function in children with cerebral palsy using Botox injections and surgery if needed. Professor Bindra has extensive experience with Collagenase injections for treating Dupuytren’s contracture both in the USA and Australia and has pioneered its use on the Gold Coast. Professor Bindra works closely with a team of hand therapists to provide comprehensive care and rehabilitation of his patients.
The Project
Profession Skills Utalised
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Respond to brief
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Research
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Communication with industry professional's
Three fellow Students and myself were selected to work with Dr Bindra initially to try and improve the SLIL (Scapholunate Interosseous Ligament) surgical process. This could be achieved through the development of new tooling or by creating work flow and process solutions.
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However, This plan changed slightly due to access limitations at the Hospital. We were only allowed to view the surgical procedures one at a time, meaning we were spread out during the day and we all viewed different surgical procedures.
The new design intent was to identify any problems or difficult moments through out the various surgeries in which we believe could be improved through re designed tooling or surgical methods and procedures
Design intent
Intitial surgery research
The Surgery
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Organise and attend meetings
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Follow strict health and safety guidelines
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Communication with professional's using industry Jargon
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Oberserve and Critically analyse an industrrial process
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Conduct research to inform design direction
Profession Skills Utalised
Patient – Late 70s female
Problem – Chronic arthritis in the Right hand
Procedure – Full removal of the Trapezium bone and the removal of bone spurs and fusion of the index and pointer distal inter-phalangeal joints (DIP).
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Tourniquet used to remove blood from hand, forearm and upper arm.
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Incision made from near the thumb metacarpo-phalangeal joints down to the top of the ulna bone. Opening tool was used to hold the skin back and locked into open position
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Further incisions made through soft tissue, radial artery was identified, and “tagged” with a red chord wraparound and moved to the side.
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Trapezium bone was located tissue was cut away from the bone and then a tool that resembled a screw removal tool was used to completely remove the tool.
(This was the first and only real problem I noticed; the bone broke apart upon removal)
I haven't found the correct name yet but this the closet to what it looked like - https://www.aliexpress.com/item/32741909080.html -
Once all the bone was removed, a part of a near by tendon was sliced and peeled back and a thread was sewn into the end of the strip of tendon.
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A hole was drilled through the bottom of the thumb metacarpal, and the part of the tendon that now resembled a piece of string was threaded through the whole using a special tool and the thread attached to the end.
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Another hole was drilled into the capitate bone using a small drill jig as a guide to ensure the right angle and depth hole was drilled.
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The thread attached to the tendon was then fixed to a bone anchor that was then screwed into the hole in the capitate.
Because the Trapezium bone had been removed, the thumb metacarpal was left hanging. So in order to support the thumb the tendon was used to “tie up” the thumb and suspend it in place.
Assessment of potential places of improvement:
Bone breaking apart
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Problems included:
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Heavily arthritic soft bone to begin with
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Tool self-tapping head too large for small bone and force of it driving in has caused fractures and eventual splitting of the bone upon removal
Potential fixes
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Drilling pilot hole first with a smaller self-tapping head to reduce the splitting force but still proving enough grab from the thread to remove the bone
Current tooling - Weitlanar retractor
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Problems included:
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Exesivly large tool -heavy and pulls on incision
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large locking mechanism
Potential fixes
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Resizing the tool - redisgining the arm opening method
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Current Trapeiziotcamy tool
Weitlaner retractor
Concept presentation
Profession Skills Utalised
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Draw detailed or techncal Illustrations
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Prepare graphics or other visual representations
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Collaborate with others to develop or refine
designs
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Present work to clents for approval
By identifying key problems though out the surgery i was able to research and study the tools being used at the points of problems.
From there i was able to ideate potential ways to improve the tools in order to alleviate the issues. Initial sketch work was used to visualise the problems and solutions. Then with further and more detailed sketch work i developed the soltions further.
I was then able to use CAD modelling software, Solidworks to create 3D models to get a better understand of the form and potential function.
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The next step was to Render the 3D models to create a realistic visulisation of the products so i could present my solutions to Dr Bindra.
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This design process is crucial as in industrial designer as it enables us to bring an idea to life. We can share our idea or solutions with any so they are able to see how we can solve the problem or adress the brief.
Conclusion
This project set out to help Dr Bindra and the medical community assess and address potential issues with various surgical procedures. The results of these potential improvements include, faster, safer and easier surgical procedures. From which both patient and surgeon could benefit.
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Three Industrial design students and i attended various surgeries, overseeing the processes. Whilst engaging with Dr Bindra and his team throughout I took notes throughout the surgery and did my best find ways of which I could improve both the tooling and the process. From there i went away and identified several potential areas that i could develop tooling to be more efficient and effective. I went through my taught design process to come up with 2 separate novel tools that I believe could be an improvement on existing tools . I then created appropriate visual representations of my tools and presented them to Dr Bindra.
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Feedback was received from Dr Bindra and i focused in on the Trapezioctamy tool. Further development was needed in a few key areas before the tool could enter the prototyping phase. The project is currently still in this phase and is still on going.
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This work placement has given me invaluable experience as an industrial designer. Never in my wildest dreams did I think I would ever be able to oversee a surgery and design a medical instrument that could have the pontetial to be used by professionals. I have learnt as an Industrial designer to be adaptable; my profession is very broad and covers many different industries. I thoroughly enjoyed studying the biomechanics of the hand to gain a better understanding of the surgery before i arrived and I believe it paid off massively. This work placement also allowed me tap into and grow my problem-solving skills, Sketching and ideation skills, 3D modelling, rendering an communications skills.
I would like to thank Dr Bindra and my Uni project convenor Kaecee Fitzgerald for this opportunity that I will never ever forget and I look forward to seeing where the rest of the project progress.
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