Evidence map›Paper›PMID 37653156›Full record

ArticleSurgical endoscopy2023

Gasless laparoscopy in rural India-registry outcomes and evaluation of the learning curve.

N Aruparayil, J Gnanaraj, A Mishra, L Bains, N Corrigan, J Brown, T Ensor, R King, B Shinkins, D Jayne

Open access · hybridAbstract read
In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

N AruparayilLeeds Institute of Medical Research, University of Leeds, Leeds, UK. n.k.aruparayil@leeds.ac.uk.ORCID 0000-0002-2898-772X
J GnanarajKarunya University, Coimbatore, India.
A MishraMaulana Azad Medical College, Delhi, India.
L BainsMaulana Azad Medical College, Delhi, India.
N CorriganLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
J BrownLeeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
T EnsorNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
R KingNuffield Centre for International Health and Development, University of Leeds, Leeds, UK.
B ShinkinsAcademic Unit of Health Economics, University of Leeds, Leeds, UK.
D JayneLeeds Institute of Medical Research, University of Leeds, Leeds, UK.
University of Leeds · GBMaulana Azad Medical College · INKarunya University · IN

Funding

Programme Grants for Applied Research 16/137/44
6 · The paper itself

Abstract

backgroundA program of gasless laparoscopy (GL) has been implemented in rural North-East India. To facilitate safe adoption, participating rural surgeons underwent rigorous training prior to independent clinical practice. An online registry was established to capture clinical data on safety and efficacy and to evaluate initial learning curves for gasless laparoscopy.

methodsSurgeons who had completed the GL training program participated in the online RedCap Registry. Patients included in the registry provided informed consent for the use of their data. Data on operative times, conversion rates, perioperative complications, length of stay, and hospital costs were collected. Fixed reference cumulative sum (CUSUM) model was used to evaluate the learning curve based on operative times and conversion rates published in the literature.

resultsFour surgeons from three rural hospitals in North-East India participated in the registry. The data were collected over 12 months, from September 2019 to August 2020. One hundred and twenty-three participants underwent GL procedures, including 109 females (88.6%) and 14 males. GL procedures included cholecystectomy, appendicectomy, tubal ligation, ovarian cystectomy, diagnostic laparoscopy, and adhesiolysis. The mean operative time was 75.3 (42.05) minutes for all the surgeries. Conversion from GL to open surgery occurred in 11.4% of participants, with 8.9% converted to conventional laparoscopy. The main reasons for conversion were the inability to secure an operative view, lack of operating space, and adhesions. The mean length of stay was 3 (2.1) days. The complication rate was 5.7%, with one postoperative death. The CUSUM analysis for GL cholecystectomy showed a longer learning curve for operative time and few conversions. The learning curve for GL tubal ligation was relatively shorter.

conclusionGasless laparoscopy can be safely implemented in the rural settings of Northeast India with appropriate training programs. Careful case selection is essential during the early stages of the surgical learning curve.

Indexed as

LaparoscopySurgeonsCholecystectomyFemaleHumansLearning CurveMaleOperative TimeRetrospective StudiesAbdominal wall liftCUSUMGasless laparoscopyLearning curveRural surgeryTraining

Identifiers

PMID37653156
PMCPMC10615921
OpenAlexW4386324903

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.