Abstract
Abstract Introduction Gasless insufflation-less laparoscopic surgery (GILLS) was introduced in rural northeast India as part of the NIHR Global Health Research Group - Surgical Technologies (GHRG-ST) project. The GILLS Registry aims to provide a reliable mechanism for monitoring the safe implementation of the GILLS technique in everyday clinical practice by the newly trained rural surgeons deemed competent in independent practice. Methods The GILLS Registry captured all gasless laparoscopic abdominal procedures for patients consenting to participate in the Registry and performed by trained rural surgeons. They attended the NIHR GHRG-ST TARGET training programme in March 2019 and proctorship in May 2019. Patients were recruited prospectively. Complications were reported using ISOS classification. The data were captured on REDCap from October 2019 to July 2020. Results Four rural surgeons from three regions of North-East India participated. Of 286 recorded procedures, 123 had general surgical and gynaecological GILLS procedures. Mean age was 34.51 (SD 11.17), 89% were female. Cholecystectomy (44%), tubal ligation (24%) and appendicectomy (16%) were the commonest procedures. More patients received regional (53%) over general anaesthesia (47%). Overall, 11% GILLS cases were converted to open and 9% to conventional laparoscopy. The intra and postoperative complication rates were both 5%. One patient died due to postoperative pancreatitis. Mean length of stay 3.02 (2.12) days. Conclusion GILLS procedure demonstrates favourable outcomes for patients in rural settings. This prospective Registry indicates that GILLS can be safely introduced in low resource settings and findings support wider adoption of GILLS technology in India. Take-home message Gas Insufflation-Less Laparoscopic Surgery (Gasless laparoscopy) can be safely introduced in low resource settings and the registry supports its wider adoption and implementation in India.
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