Innovation
Prehabilitation
Krishna co-leads the PREPARE for surgery prehabilitation. This innovative concept is based on the rationale that providing patients with a physical and psychological reserve would help them cope with the stress of cancer treatment and surgery as described in this BMJ paper. Co-developed in partnership with his colleague, Venetia Wynter-Blyth, consultant cancer nurse, this programme is unique in the emphasis that is placed on the value of psychological health in patients undergoing cancer treatment as explained in this piece on BBC Radio 4 .
PREPARE has won numerous awards including the BMJ awards in 2017 for Surgical team of the year and Patient engagement.
ONKOHEALTH
Krishna and his co-founder, Venetia Wynter-Blyth, have founded Onko to deliver personalised programmes of health optimisation and support to people with cancer at all stages of the cancer pathway. Based on an innovative methodology that they have pioneered, their team can deliver the programmes remotely using digital technology integrated with wearable devices. Patients can access their programme either in a face to face format from a 'Hub' in London or remotely through a bespoke digital solution (under development).
Their ambition is to provide these programmes globally in order to provide support of people with cancer anywhere in the world.
Some insurers are currently approving the programmes for patients undergoing private cancer treatment in London and beyond.
Robotic Surgery
While Krishna was the first to perform robotic bariatric surgery in the UK, he doesn’t believe that the current technology offers any benefits over laparoscopic surgery. The technology is not cost-effective nor is it associated with any advantages to patients in the clinical practice of laparoscopic surgeons like Krishna, who has performed over 3000 laparoscopic surgeries.
However, robotic surgery definitely has a place in future surgical practice once the limitations of the current technology such as size and cost are reduced. There are number of new surgical robots which are currently being developed and tested, which may address many of the limitations. Krishna believes that the future is exciting and looks forward to working with these developers.
Surgical Education
Over the years, Krishna has undertaken research on developing and validating a number of simulated environments for training surgeons and operating theatre teams. As part of his research degree, Krishna developed the Simulated Operating Theatre for training technical and non-technical skills in surgeons.
He has validated a number for virtual reality simulators for improving technical skills in laparoscopy and endoscopy.
Krishna has also developed digital solutions for the WHO peri-operative checklist and for guidelines for implementing guidelines for Surgical Site Infections (SSI).