Laparoscopic Surgery in Low-income and Limited-resource Settings: Does It safely add Value? A Review of 2,901 Laparoscopic Gynecologic Procedures

Abstract

Objectives: Of the 234 million surgeries conducted yearly worldwide, only 3.5% are carried out in low-income countries. Known advantages exist to laparoscopic surgery, and it is widely utilized in high-income countries; however, many barriers exist to uptake in low-income countries. Since 1992, laparoscopic surgery has been successfully undertaken in various rural public hospitals in Kenya. We sought to review outcomes of laparoscopic surgeries performed by our group in these facilities. Materials and methods: Between 1992 and 2015, 3,119 laparoscopic procedures were performed at 17 rural hospitals in Kenya as a part of the Round Table’s “Week of Healing Project.” The medical and operative records of all patients who underwent gynecological laparoscopic surgery were retrospectively reviewed for outcomes. Results: During the reporting period, 2,901 cases performed were gynecologic procedures; the mean age of patients was 34.2. Forty-one complications were encountered (1.41%), and one death (0.03%) occurred secondary to hemorrhage WJOLS