Improving neurosurgery workflows

Reducing frequent instrument swapping during surgery

Muhammad Shahzad, an NHS neurosurgeon, wanted to find a solution to a significant challenge in neurosurgery: the frequent swapping of instruments during the removal of meningiomas. This constant switching disrupts focus, prolongs procedures and increases the time patients spend under anaesthesia.

Working in collaboration with the Royal College of Surgeons of England Innovation Hub (I-Hub), Team Consulting helped Shahzad develop a concept for a new surgical tool that has the potential to solve this challenge by reducing cognitive load for surgeons and optimising the clinical procedure.

Human factors | Mechanical engineering | Industrial design | Front end innovation

Neurosurgeon looking down microscope at patient’s head

The challenge of instrument swapping in neurosurgery

During neurosurgical procedures, when looking through a microscope surgeons are frequently forced to swap instruments for coagulation and cutting, sometimes 30 to 100 times. This can lead to reduced focus, user fatigue and headaches, as well as longer operating times. Not only does this increase the time patients must spend under anaesthesia, it also increases the cost and carbon impact of the operation.

Shahzad wanted to explore a solution that would prevent these interruptions, allowing neurosurgery operations to be performed faster and more effectively.

Innovation workshop with surgeons

We began the process by hosting an innovation workshop with the I-Hub, where we brought together surgeons from diverse specialisms to explore Shahzad’s challenge and collaboratively ideate potential solutions.

Hosting an innovation workshop proved invaluable in the development. We were able to gain practical insights from practising surgeons, not only brainstorming potential solutions but discussing specific design requirements as well.
Tom Etheridge, Senior Industrial Design Consultant, Team Consulting

Rapid concept generation

Working closely with Shahzad, our experts identified several potential concepts to address the challenge, from combining micro scissors with forceps, to integrating suction or introducing modular, detachable components.

Each concept was then carefully assessed by a multidisciplinary team based on factors such as clinical feasibility, technical robustness and usability, to identify the best solution to take forward.

A novel solution to neurosurgery resection

The chosen concept features a novel ‘two-in-one’ approach which integrates a retractable blade with bipolar forceps. This enables the surgeon to effortlessly switch between bipolar action to cutting via a finger trigger, without the need to disengage from the microscope.

Surgeon-centred design

Introducing any significant changes to surgical procedures can be problematic, as surgeons are trained to use existing tools to an exact degree. Drawing on Shahzad and his colleague’s clinical expertise throughout the development, we focused on ensuring the design would meet real user needs and provide the same degree of precision, cutting and coagulation as existing tools.

We achieved this by analysing existing bipolars to understand both the grip position and balance of the tools. Working across engineering, design and human factors, we then iteratively developed various forms, using 3D printing and user testing to optimise the design for handling, weight balance and actuation method.

Technical de-risking

Our mechanical engineers applied Finite Element Analysis (FEA) to ensure the tool would provide structural robustness, despite the thinned internal section. The result showed comparable structural performance to existing forceps.

While the forceps were designed to be well balanced in a surgeons’ hands, during user testing we noticed a key challenge was presented when the surgeon moves a finger to retract the blade. To solve this, we identified alternative locations for the retracting trigger.
Millie Rampling, Consultant Mechanical Engineer, Team Consulting

Outcome

The outcome was a thoughtfully developed concept that directly addresses a real surgical challenge, shaped by the practical needs of surgeons. This progress was made possible through close collaboration with the I-Hub, which enabled meaningful engagement between clinical and technical teams.

I think it’s really important to have collaboration between the Royal College of Surgeons of England I-Hub and our partners, such as Team Consulting, because if you’re really going to tackle problems, there’s no point in doing what you are already aware of. But, being able to bring the clinical perspective to the engineering and the engineering perspective to the clinical means you can start to think about the solutions to those big problems.
Ryan Kerstein, Plastic Surgeon & Lead for the Royal College of Surgeons of England I-Hub

Working alongside Shahzad and the I-Hub team has been an incredibly powerful way to bring surgeons and device developers together to solve a real clinical challenge. The insights we’ve gained has helped ensure this solution is both relevant and grounded in the needs of real-world surgical practice.
Andrea Pisa, Head of Human Factors - Product Development, Team Consulting