# KeyScope: The Key to Sustainable Cancer Diagnosis and Treatment in Uganda

> **NIH NIH U01** · DUKE UNIVERSITY · 2022 · $588,819

## Abstract

Abstract
Laparoscopic surgery is the standard of care in high-income countries for many cancer operations in the chest
and abdomen. Laparoscopic surgery avoids large incisions by using a tiny camera and fine instruments
manipulated through keyhole incisions, but it is generally unavailable in low- and middle-income countries
(LMICs) due to high cost of installment, lack of qualified maintenance personnel, unreliable electricity
and shortage of consumable items. Patients in LMICs would benefit from laparoscopic surgery, as
advantages include: decreased pain, improved recovery time, fewer wound infections, and shorter hospital
stays. Laparoscopic surgery would reduce recovery time, enabling patients to return to home and work more
quickly, thereby mitigating impoverishing health expenditure.
KeyScope and KeyLoop (collectively called KeySuite) are laparoscopic prototypes that we have
designed for the resources, needs and challenges of LMICs. KeyScope is a laparoscope that can be
made for $150 (cost of goods), plugs into a laptop computer to display images during surgery, exists as a
single unit without complicated assembly and is sterilizable by immersion in Cidex. It links to a tele-mentoring
application so that experienced surgeons can mentor surgeons in capacity-building partnerships. KeyLoop is a
laparoscopic retractor that lifts the abdominal wall during surgery, obviating the need for a constant power
supply and medical-grade carbon dioxide. This would enable laparoscopic surgery to be performed in rural
hospitals, where most patients live in LMICs, and increase access in tertiary centers where laparoscopic
equipment is rare and expensive. We describe a multi-disciplinary collaboration between surgeons,
engineers, oncologists, attorneys, global health experts and business executives to take this technology
to the next stage.
We will perform a clinical First-in-Human study at the Uganda Cancer Institute. Ugandan surgeons will use the
KeySuite devices to perform biopsies of intra-abdominal tumors. Primary outcome will be the ability to perform
biopsies laparoscopically without conversion to open surgery. Secondary outcomes include: 1) device
feasibility and safety data and 2) patient satisfaction.
We will demonstrate that KeySuite devices can be constructed in Uganda, through the Duke-MUK Shipping
Container Makerspace. We will create a bill of materials, manufacturing process instructions, training videos,
and measures of quality control. Once we have achieved exceptional construction quality, we will transfer this
work to the Uganda Industrial Research Institute (UIRI) which will move the KeySuite to a product for
commercialization. Using the WHO Good Manufacturing Practices (GMP) we will establish quality assurance
protocols for sustainable local manufacturing and regulatory approval of the KeyScope and KeyLoop through
the Uganda National Drug Authority and CE mark.

## Key facts

- **NIH application ID:** 10416540
- **Project number:** 1U01CA269190-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** TAMARA N FITZGERALD
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $588,819
- **Award type:** 1
- **Project period:** 2022-08-04 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10416540

## Citation

> US National Institutes of Health, RePORTER application 10416540, KeyScope: The Key to Sustainable Cancer Diagnosis and Treatment in Uganda (1U01CA269190-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10416540. Licensed CC0.

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