Laparoscopy is a major breakthrough in surgery. By using gas to inflate the abdomen, surgeons are able to drastically increase their visibility and thus can work through very small incisions to do major abdominal surgeries. The benefits are numerous including smaller scars, quicker recovery, and shorter time to return to work (which decreases lost wages). The problem? It requires a constant supply of carbon dioxide gas to be pumped in.


While this is usually not a problem in a high-resource setting, how do you do this in a low-resource context where even electricity is often unavailable? No gas, no problem? This was the thought by Noel Aruparyil and William Bolton. “The Hindi word ‘Jugaad’ describes an improvised or makeshift solution using scarce resources. It’s a way of life in India, where washing machines are used for whipping up yogurt drinks, but it’s also an innovation theory…” Conventional laparoscopy would never reach rural areas, but by designing a system which would work without gas, it could be a bridge to get healthcare workers trained and patients benefitting from this important technology.


This is the idea of Jugaad innovation. If you see a problem, come up with a solution – but just don’t come up with any solution, come up with one that is frugal, flexible, affordable, of good quality, and sustainable. Join us as we talk about innovation in this vital procedure and the process of medical technology as a whole!

Dr William Bolton and Dr Noel Aruparayil






“Gasless lift laparoscopy, Jugaad Innovation, and Research”

Dr Noel Aruparayil is a Clinical Research Fellow and PhD student with the NIHR Global Health Research Group – Surgical Technologies, University of Leeds. His research work involves training, evaluation and implementation of laparoscopic surgery in low-resource settings – India and Kenya. He is the current President of GASOC – a multi-speciality global surgery advocacy trainees organisation in the UK and Ireland. He also sits on the permanent council of the G4 Alliance who are building political priority for global surgical care.


Dr William Bolton is an NIHR Clinical Research Fellow in the Global Health Research Group Surgical Technologies in Leeds, taking time out of training to complete a PhD on surgical technologies for application in low and middle-income countries. His research interests include the innovation and evaluation of novel surgical technology, its applications to low-resource settings and clinical trial design in Global Surgery. Recent studies include investigating the use of virtual reality in surgical training, a clinical trial of external fixation for fractures in Sierra Leone and developing innovation pathways in global health. His clinical interests lie in neurosurgery and emergency general and trauma surgery. He is also a Co-Founder and National Director for a student and early career medtech innovation collaborative called the MedTech Foundation, where he delivers innovation training and research internships. He is the Association of Surgeons in Training (ASiT) Innovation Lead supported by BBraun UK where he develops opportunities for trainees to gain experience in surgical innovation. He has been a TEDx Speaker and has won several awards including the ASiT Swann Morton Medal and the Translate MedTech Scholarship for the Biomedical Innovation and Entrepreneurship Certificate Programme from the Institute for Biomedical Entrepreneurship (IBE).