Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance

BACKGROUND: Successful laparoscopic programs in low- and middle-income countries can be difficult to implement because of expensive equipment and limited skills. We describe the establishment of a gynecologic laparoscopic program through collaboration between two hospitals, namely one in New York (a...

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Main Authors: Xun Lian, MD, Emilia Selemane, MD, Sibone Mocumbi, MD, Naima Guterriez, MD, Sierra Washington, MD, MSc
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:AJOG Global Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666577825000711
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author Xun Lian, MD
Emilia Selemane, MD
Sibone Mocumbi, MD
Naima Guterriez, MD
Sierra Washington, MD, MSc
author_facet Xun Lian, MD
Emilia Selemane, MD
Sibone Mocumbi, MD
Naima Guterriez, MD
Sierra Washington, MD, MSc
author_sort Xun Lian, MD
collection DOAJ
description BACKGROUND: Successful laparoscopic programs in low- and middle-income countries can be difficult to implement because of expensive equipment and limited skills. We describe the establishment of a gynecologic laparoscopic program through collaboration between two hospitals, namely one in New York (a high-income setting) and the other in Mozambique (a low-income setting). OBJECTIVE: This study aimed to evaluate the safety of a gynecologic laparoscopic program through a novel recycling program and collaboration between two hospitals. STUDY DESIGN: This was a prospective cohort study. RESULTS: The patient characteristics, length of stay, and postoperative complications were evaluated. A total of 29 patients were identified. All underwent an operative laparoscopy. The ages ranged from 23 to 52 years. The procedures included 8 ovarian cystectomies, 6 bilateral salpingectomies, 10 hysterectomies, and 4 myomectomies. The majority of patients were discharged on the same day of surgery (19 of 29). There were no conversions to laparotomy or intraoperative blood transfusions. Four patients were lost to follow-up. No postoperative complications were noted up to two months postoperatively. CONCLUSION: This case series provides preliminary evidence that the re-use and recycling of needed instrumentation can be implemented in laparoscopy programs in low-income countries without compromising patient safety. However, larger cohorts are required to be certain.
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spelling doaj-art-b6fa6edcd3d54e059c1b8ea8e8d0441b2025-08-20T02:35:19ZengElsevierAJOG Global Reports2666-57782025-05-015210051010.1016/j.xagr.2025.100510Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a GlanceXun Lian, MD0Emilia Selemane, MD1Sibone Mocumbi, MD2Naima Guterriez, MD3Sierra Washington, MD, MSc4Department of Obstetrics and Gynecology, Stony Brook Medicine Stony Brook, NY (Lian and Washington); Corresponding author: Xun Lian, MD.Department of Obstetrics and Gynecology, Hospital Central de Maputo, Maputo, Mozambique (Selemane, Mocumbi, Guterriez, and Washington).Department of Obstetrics and Gynecology, Hospital Central de Maputo, Maputo, Mozambique (Selemane, Mocumbi, Guterriez, and Washington).Department of Obstetrics and Gynecology, Hospital Central de Maputo, Maputo, Mozambique (Selemane, Mocumbi, Guterriez, and Washington).Department of Obstetrics and Gynecology, Stony Brook Medicine Stony Brook, NY (Lian and Washington); Department of Obstetrics and Gynecology, Hospital Central de Maputo, Maputo, Mozambique (Selemane, Mocumbi, Guterriez, and Washington).BACKGROUND: Successful laparoscopic programs in low- and middle-income countries can be difficult to implement because of expensive equipment and limited skills. We describe the establishment of a gynecologic laparoscopic program through collaboration between two hospitals, namely one in New York (a high-income setting) and the other in Mozambique (a low-income setting). OBJECTIVE: This study aimed to evaluate the safety of a gynecologic laparoscopic program through a novel recycling program and collaboration between two hospitals. STUDY DESIGN: This was a prospective cohort study. RESULTS: The patient characteristics, length of stay, and postoperative complications were evaluated. A total of 29 patients were identified. All underwent an operative laparoscopy. The ages ranged from 23 to 52 years. The procedures included 8 ovarian cystectomies, 6 bilateral salpingectomies, 10 hysterectomies, and 4 myomectomies. The majority of patients were discharged on the same day of surgery (19 of 29). There were no conversions to laparotomy or intraoperative blood transfusions. Four patients were lost to follow-up. No postoperative complications were noted up to two months postoperatively. CONCLUSION: This case series provides preliminary evidence that the re-use and recycling of needed instrumentation can be implemented in laparoscopy programs in low-income countries without compromising patient safety. However, larger cohorts are required to be certain.http://www.sciencedirect.com/science/article/pii/S2666577825000711global healthgynecologic surgerylaparoscopyrecycling program
spellingShingle Xun Lian, MD
Emilia Selemane, MD
Sibone Mocumbi, MD
Naima Guterriez, MD
Sierra Washington, MD, MSc
Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
AJOG Global Reports
global health
gynecologic surgery
laparoscopy
recycling program
title Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
title_full Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
title_fullStr Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
title_full_unstemmed Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
title_short Building a safe operative laparoscopy service in a resource-constrained setting: a case seriesAJOG Global Reports at a Glance
title_sort building a safe operative laparoscopy service in a resource constrained setting a case seriesajog global reports at a glance
topic global health
gynecologic surgery
laparoscopy
recycling program
url http://www.sciencedirect.com/science/article/pii/S2666577825000711
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