How often does it happen. You run into a problem and think: ‘With today’s technology there must be a good solution’. This also happened to clinical physicist Dr. Bas Gobets of the Department of Radiotherapy in the LUMC. He saw that there was no easy way to protect healthy body parts against radiation damage in radiation treatments for cutaneous lymphomas (a type of skin cancer).
He presented his problem to the Medical Technology consultancy at the LUMC. Together they came up with the idea of a ‘Total skin irradiation (TSI) frame’, a device that makes radiation treatments for skin cancer more precise and easier. Thanks to the help of the Design & Prototyping subdepartment, the innovation was recently used in practice for the first time.
Specialist radiation treatment
Cutaneous lymphoma is a form of skin cancer in which a group of white blood cells grows and divides uncontrollably in the skin. The LUMC is a national and international center of expertise in the field of cutaneous lymphomas, and the only hospital in the Netherlands that offers treatment with total skin irradiation. Malignant cells are often found in the skin all over the body. In that case, the entire skin is irradiated with electrons. Sometimes the disease is limited to the skin of certain parts of the body. In those cases, healthy areas of the skin must be properly shielded against radiation during treatment.
The radiation treatment has always been performed safely. However, provisional solutions were often required. Healthy body parts were covered with a large heavy wooden chipboard and a sheet of plexiglass. “It didn’t look very professional to the patient, and it was sometimes hard work for our employees. For example, to shield the chest, a plate was hung on chains in front of the patient. That was not very flexible, and also did not look good,” says Gobets.
Total skin irradiation frame
With the new TSI frame, these problems are a thing of the past. The device is a movable plexiglass shielding fence with several small doors. The plexiglass blocks the radiation. By opening or closing doors, a specific body part can be irradiated or shielded much more precisely and easily than was previously possible. A lift system is also incorporated into the rack, allowing precise adjustment of the height of the patient relative to the guard.
From drawing board to practice
How do you get such an innovation from the drawing board to practice? According to advisor dr.ir. Susanne van Engelen is involved in this a lot. Fortunately, the LUMC has ample experience for this. At the Design & Prototyping subdepartment, they have been inventing and making devices that do not yet exist for years. Together with instrumentation technician Piet Bakkenes, Van Engelen was involved in realizing the TSI frame.
They notice that stumbling blocks in healthcare can often be solved relatively easily thanks to a simple innovation. “We help specialists to look at the problem in a targeted manner,” says Van Engelen. For this, the consultancy always goes back to the first step, including the TSI frame. “We really inquired about what the problem was in practice. We started sparring with the department to come up with a tailor-made solution. We combined our knowledge with research on radiation protection that was carried out by the department itself.”
Process of compromise
According to Bakkenes, creating a good innovation is an ongoing process of finding compromises between what the user wants and what is technically possible. Functionality is the magic word here. “The user has been involved in every step of the development. With the TSI frame, we tested and evaluated everything, so we now know for sure that the innovation works properly,” he says. “We also ensured that the device complies with all rules and guidelines, such as the MDR, and can be used safely,” adds Van Engelen.
The department provides tailor-made solutions, with which they help patient care a little further. In any case, the Radiotherapy department is only too happy with the new TSI frame. “It is great that we can now help the patient faster and better with an innovation that also looks professional,” says Gobets. The heavy wooden chipboard has now been put in the corner in the Radiotherapy department and no longer needs to be used as a provisional solution.
