Article (Scientific journals)
Assessment of resource capacity and barriers to effective practice of laparoscopic surgery in training hospitals affiliated with the College of Surgeons of East, Central and Southern Africa (COSECSA).
Nyundo, Martin; Umugwaneza, Nathalie; Bekele, Abebe et al.
2023In Surgical Endoscopy, 37, p. 5121-5128
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Keywords :
Barriers to laparoscopy; Global surgery; Laparoscopic surgery; Resources capacity; Sub-Saharan countries; Surgery
Abstract :
[en] [en] BACKGROUND: The adoption and accessibility of laparoscopy have been serious issues in countries with limited resources, and for varied reasons. This study assessed resource capacity and barriers to the effective practice of laparoscopic surgery in training hospitals affiliated with the College of Surgeons of East, Central and Southern Africa (COSECSA). METHODS: A multi-country survey was conducted from January 2021 to October 2021 using a questionnaire distributed to surgeons in COSECSA hospitals located in 16 different countries. Available resources and surgical volume were assessed, and the barriers to routinely performing laparoscopy were determined. RESULTS: Ninety-four surgeons working in 44 different hospitals from 16 countries participated in the survey. The majority of respondents were general surgeons (n = 75, 79.7%). Other specialties included urology (n = 12, 12.8%) and pediatric surgery (n = 7, 7.4%). Senior surgeons accounted for 60.6% of participants, more than 40% had a managerial position and approximately 20% were surgical trainees. Most respondents practiced in public hospitals (n = 66, 70.2%). A median of three surgeons per hospital performed laparoscopic surgery with, on average, two laparoscopic towers and two sets of laparoscopic instruments available. A median of 10 procedures was carried out per month. The cost of laparoscopic procedures and laparoscopic consumables were reported as being covered by some health insurance payments in 76.9% and 48.4% of cases, respectively. Cholecystectomy was the most commonly reported laparoscopic procedure performed. The five top barriers to performing laparoscopic surgery were: a lack of consumables, a limited quantity of equipment, a lack of skilled surgeons, the high cost of laparoscopic procedures and complicated cases. In addition, having access to skilled anesthesiologists and anesthesia equipment, carbon dioxide, a consistent electric power supply and equipment maintenance were cited as significant challenges. CONCLUSION: The practice of laparoscopy is currently limited in COSECSA countries due to a scarcity of skilled staff and the lack of a funding plan to make laparoscopic services accessible. Therefore, policymakers and stakeholders should take strategic measures to respond to this need.
Disciplines :
Surgery
Author, co-author :
Nyundo, Martin  ;  Université de Liège - ULiège > Faculté de Médecine > Form. doct. sc. méd. (paysage) ; Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda. nyundomartin@gmail.com
Umugwaneza, Nathalie;  Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda
Bekele, Abebe;  School of Medicine, University of Global Health Equity, Kigali, Rwanda
Chikoya, Laston;  Department of Neurosurgery, Levy Mwanawasa Medical University, Lusaka, Zambia
Gashegu, Julien;  Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda ; Clinical Anatomy Department, University of Rwanda, Kigali, Rwanda
Detry, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service de chirurgie abdo, sénologique, endocrine et de transplantation
Language :
English
Title :
Assessment of resource capacity and barriers to effective practice of laparoscopic surgery in training hospitals affiliated with the College of Surgeons of East, Central and Southern Africa (COSECSA).
Publication date :
17 March 2023
Journal title :
Surgical Endoscopy
ISSN :
0930-2794
eISSN :
1432-2218
Publisher :
Springer Science and Business Media LLC, Germany
Volume :
37
Pages :
5121-5128
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 18 April 2023

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