To comply with the large global need for surgery, surgical equipment that fits the challenging environment in low- and middle-income countries (LMICs) should be designed. The aim of this study is to present a context-specific design of an electrosurgical unit (ESU) and a monopolar handheld to improve global access to surgery. This paper presents both a detailed description of electrosurgery in clinical practice in LMICs and the design of an ESU generator and monopolar handheld for this specific setting. Extensive fieldwork (by means of surveys, interviews, observations, and collection of maintenance records) was done by authors RO, KO, and LH. Feedback from users working in Kenya on the first demonstrator designs was obtained, after which the designs were adapted into conceptual prototypes. These were further evaluated by surveying respondents who attended the annual meeting of the College of Surgeons of East, Central, and Southern Africa (COSECSA) in Kigali, Rwanda in December 2018. Conceptual prototypes were developed for (a) an affordable ESU that is compact and battery powered and (b) a robust reusable monopolar handheld that can be cleaned in the autoclave and by chemicals (e.g., glutaraldehyde solution). The conceptual prototypes were positively received by the 51 respondents of the survey. The findings from the field work and the feedback from users during the design phase have led to a clear understanding of the specific needs and potential solutions. The presented conceptual prototypes need to be further developed into functional prototypes, which could be implemented in Kenya and other settings for further evaluation.

More than a million times every year, an ambulance is deployed in the Netherlands. Of these instances, 87% of the patients will be administered intravenous (IV) fluids. In the current situation, the IV bag always needs to be held above the patient to function properly. This action requires an extra pair of hands, which is very inefficient and can result in the loss of precious time that could otherwise be directed at the patient. Besides needing an extra pair of hands, there is also a chance of air bubbles entering the patient through the drip feed. The novel drip chamber design proposed in this paper aims to solve these problems, as it enables the IV bag to be placed in any orientation and in any manner relative to the patient with a negligible number of air bubbles entering the drip feed. This novel drip chamber was tested in an experimental setting in different orientations and at different flowrates. From the test results, it can be concluded that at a clinical relevant flowrate, a negligible number of air bubbles were present within the IV system. Because of the ease of use of the novel drip chamber and the fact that it is fool-proof, cost-efficient, and shows promising test results, future research on several aspects could make this product a promising addition to health care.