Challenges faced by frugal surgical innovations

Abstract

Surgical innovations (SIs) are central to the development of surgical science. However, advanced SIs, usually with their cutting-edge technology, have high price tags which make them inaccessible to the majority of the population in low- and middle-income countries (LMICs). Frugal SIs (FSIs) or low-cost SIs (LCSIs) are developed in response to such economic challenges. This frugality is much more than a cost-effective alternative; it is rooted in heuristic-based decisions guided by the experience, learning, judgement and ingenuity of people working at the grassroots to optimise limited resources.1 The resultant FSIs are simple, safe, affordable, effective, ethical and evidence-based customised local solutions in LMICs.2 By making surgical procedures more affordable and, therefore, cost-effective, FSIs have the potential to revolutionise surgery globally and improve surgical care for millions, and not just in LMICs. These solutions, however, face challenges at every step of the way; potential responses thereto are documented in Table 1.3–20