• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

The Globalization of Laparoscopic Surgery: Translating Laparoscopic Surgical Practice Into Resource-restricted Contexts

Ian Choy, BEng, MEd, MD, Simon Kitto, DipEd, PhD, Adu-Aryee Nii, MD, MHPE, Allan Okrainec, MD, MHPE

Div. General Surgery, The Wilson Centre, Temerity/Chang Telesimulation Centre, Toronto Western Hospital, University Health Network; University of Toronto; Korle-Bu Teaching Hospital, University of Ghana;

INTRODUCTION
The adoption of laparoscopic surgery in Africa has been sporadic and minimal. While the most commonly cited explanation for this has been an apparent lack of resources and training, recent studies and numerous training courses have demonstrated that these constraints may not be as significant as previously denoted in the literature. Moreover, there has been a growing interest amongst the surgical community, and more specifically surgical societies and academic institutions, to develop laparoscopic programs in resource restricted contexts. The overall objective of this study was to explore and analyze the potential barriers to the adoption of laparoscopic surgery in a resource restricted hospital, with a view to inform future development of laparoscopic surgical training programs in these contexts. More specifically, this study aimed to: 1) Identify the key actors and institutional processes in the hospital environment that affect the adoption of laparoscopic surgery, 2) identify surgical and institutional attitudes towards laparoscopic surgical practice, and 3) explore how these actors and processes affect the adoption of laparoscopic surgery.

METHODS AND PROCEDURES
This qualitative study employed a case study design to frame the investigation of facilitators and barriers to the adoption of laparoscopic surgery in a tertiary hospital in Sub-Saharan Africa. The hospital had purchased laparoscopic equipment 4 years prior to this study, and a number of surgeons at this hospital had undergone FLS training 2 years afterwards. The exploratory case study employed a combination of over 600 hours of participant observation, 13 semi-structured interviews and a discourse analysis of relevant documents over three months. During this time, a remote telesimulation FLS course was conducted on campus and this was also observed. A thematic analysis was conducted iteratively throughout the data collection period. In addition, data triangulation enhanced the rigour and depth of the analysis. The study findings were further explored and connected to current literature about knowledge translation and laparoscopic surgical training programs.

RESULTS
The study findings indicated that aside from resource constraints and training limitations, there were several other significant contextual barriers to the adoption of laparoscopic surgery. More specifically, cultural, social and institutional barriers directly influenced the partial uptake of laparoscopic surgery. Additionally, the opinions, attitudes and incentives of local surgeons towards laparoscopic surgery often varied significantly from those of their Western colleagues. Consequently, this led to constant negotiation concerning global pressures and local needs, which influenced training sessions and clinical practice.

CONCLUSIONS
This exploratory case-study approach to examining the barriers to the adoption of laparoscopic surgery in a resource restricted context exemplifies a novel approach to addressing issues that have plagued surgeons across low to middle income countries for many years. An understanding of such barriers is an essential step in translating new knowledge into tangible practice changes and clinical outcomes. This study can inform the development of future laparoscopic training curricula and the implementation of training programs in resource-restricted countries.


Session: Podium Presentation

Program Number: S113

86

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2013 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons