The Responsible Use of Minimally Invasive Surgery in Remote Areas of Brazil: Feasibility and Safety of a Temporary Gynecologic Operative Expedition

Abstract

Abstract Objective: To evaluate the feasibility and safety of a novel model for providing minimally invasive surgical (MIS) care to underserved populations. Design: A prospective pilot study with patients affected by diverse benign pathologies of the female urogenital tract undergoing MIS in the context of a temporary expedition. Methods: In 2013, the Bandeira Cientifica Project implemented the use of MIS in one of the most underserved areas of Brazil. Results: During 4 days, 54 different procedures were performed on a cohort of 30 selected women. The mean age of the patients was 44.5 years (SD 8.3), while body mass index averaged 28.4 kg/m2 (SD 4.3). The primary indications for surgery were as follows: 14 symptomatic uterine leiomyomatosis/adenomyosis, 6 stress urinary incontinence, 6 endometriosis, and 4 pelvic floor defects. Forty percent of the patients underwent laparoscopy, 53% vaginal surgery, and 7% combined procedures. The mean estimated blood loss and operative time were 148 cc (0–1000) and 94 (...