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Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting

Introduction  This study analyzes barriers to the adoption of emergency laparoscopy (EL), safety, and accessibility in a low-resource setting of a low- and middle-income country (LMIC). Methods  In this prospective observational study, patients with blunt trauma abdomen (BTA) who required exploratio...

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Autores principales: Kumar, Rahul, Mishra, Arpan, Damde, Harikrishna, Yadav, Prasant, Yadav, Sanjay Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Thieme Medical Publishers, Inc. 2023
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9984267/
https://www.ncbi.nlm.nih.gov/pubmed/36873295
http://dx.doi.org/10.1055/s-0043-1761951
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author Kumar, Rahul
Mishra, Arpan
Damde, Harikrishna
Yadav, Prasant
Yadav, Sanjay Kumar
author_facet Kumar, Rahul
Mishra, Arpan
Damde, Harikrishna
Yadav, Prasant
Yadav, Sanjay Kumar
author_sort Kumar, Rahul
collection PubMed
description Introduction  This study analyzes barriers to the adoption of emergency laparoscopy (EL), safety, and accessibility in a low-resource setting of a low- and middle-income country (LMIC). Methods  In this prospective observational study, patients with blunt trauma abdomen (BTA) who required exploration were included and divided into two groups—open exploration (open surgery [OSx]) and laparoscopic exploration (laparoscopic surgery [LSx]). Data were compiled and analyzed. Results  Out of 94 BTA patients, 66 required exploration, and the rest were managed conservatively. Out of 66 patients, 42 were in OSx and 24 were in LSx, reason for not selecting LSx was the surgeon's preference for OSx in 26 patients and the lack of availability of operation theater (OT) slots in 16 patients. LSx even after indication was less likely if patients had preoperative evidence of perforation peritonitis. Conclusion  Lack of resources (OT availability and trained personnel) are barriers to the adoption of emergency LSx in low-resource settings.
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spelling pubmed-99842672023-03-04 Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting Kumar, Rahul Mishra, Arpan Damde, Harikrishna Yadav, Prasant Yadav, Sanjay Kumar Surg J (N Y) Introduction  This study analyzes barriers to the adoption of emergency laparoscopy (EL), safety, and accessibility in a low-resource setting of a low- and middle-income country (LMIC). Methods  In this prospective observational study, patients with blunt trauma abdomen (BTA) who required exploration were included and divided into two groups—open exploration (open surgery [OSx]) and laparoscopic exploration (laparoscopic surgery [LSx]). Data were compiled and analyzed. Results  Out of 94 BTA patients, 66 required exploration, and the rest were managed conservatively. Out of 66 patients, 42 were in OSx and 24 were in LSx, reason for not selecting LSx was the surgeon's preference for OSx in 26 patients and the lack of availability of operation theater (OT) slots in 16 patients. LSx even after indication was less likely if patients had preoperative evidence of perforation peritonitis. Conclusion  Lack of resources (OT availability and trained personnel) are barriers to the adoption of emergency LSx in low-resource settings. Thieme Medical Publishers, Inc. 2023-03-03 /pmc/articles/PMC9984267/ /pubmed/36873295 http://dx.doi.org/10.1055/s-0043-1761951 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ) https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Kumar, Rahul
Mishra, Arpan
Damde, Harikrishna
Yadav, Prasant
Yadav, Sanjay Kumar
Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title_full Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title_fullStr Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title_full_unstemmed Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title_short Access, Safety, and Barriers in Adoption of Emergency Laparoscopy Surgery for Trauma Patients in a Low-Resource Setting
title_sort access, safety, and barriers in adoption of emergency laparoscopy surgery for trauma patients in a low-resource setting
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9984267/
https://www.ncbi.nlm.nih.gov/pubmed/36873295
http://dx.doi.org/10.1055/s-0043-1761951
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