He worked as a professor of gynecology in Sion hospital when the Salem steel ring retractor had been designed. (Representational Image)
A technique fashioned by a city gynaecologist in a government hospital that can single-handedly conduct a Cesarean delivery is an innovation which is being passed onto medical students. But the technique reserved for only emergency situations has not been adopted by many doctors.
The “crude” innovation involves a Salem steel ring with clips to hold abdominal layers wide open while a doctor delivers a baby in situations where there are no staff members to assist the surgery.
“Necessity is the mother of invention. Routine strikes by hospital staff prompted me to get the ring made,” says Dr Ganesh Shinde who got the clips attached to a Salem steel ring in a Goregaon iron workshop in 2002 during a doctors’ strike.
He worked as a professor of gynecology in Sion hospital when the Salem steel ring retractor had been designed.
“When resident doctors go on strike, the workload shifts to all senior doctors. We saw situations where a Cesarean had to be conducted urgently and there was no staff to help,” Shinde said. Generally, assistants hold the ring and a surgeon operates.
Since 2002, he has used the device over a dozen times to conduct Cesarean surgeries alone. Now, a dean at Dr RN Cooper hospital, Shinde teaches his batch about the application of a retractor, although he does not advise his students to use the technique alone.
“There are ethical issues involved in using such untested innovations. But I use it only during emergencies when saving a life is more important,” he said. The technique, however, is not popular with other doctors in city.
“Usually, someone who is assisting in a delivery puts the retractor. The instrument must be a replacement for an assistant. But an assistant is needed not only for retraction but also to avert other emergencies like blood loss or other complications,” said Dr P Trivedi, the former president of Federation of Obstetric and Gynaecological Societies of India (FOGSI) and a gynaecologist with Rajawadi hospital.
According to him, such techniques may be used in rural areas where there is less man power. But they must only be used in the presence of trained staff members. The technique is discussed in classes and as part of a thesis in medical colleges under the Brihanmumbai Municipal Corporation, Shinde said.
“Any instrument that comes with innovation, which is not certified, is a subjective choice for a gynaecologist. Some techniques get popular. But we prefer a nurse to an instrument for safety reasons,” said gynaecologist Dr Sangeeta Pikale adding that doctors keep coming up with innovations that help ease the process during routine surgeries.
