ArticleSurgical endoscopy2024
Laparoscopy experience in East, Central, and Southern Africa: insights from operative case volume analysis.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Barriers and facilitators to implementing laparoscopic surgery in low- and middle-income countries: a systematic review using the consolidated framework for implementation research.Surgical endoscopy · 2026Review
- Transforming Surgical Training: The Evolution of the COSECSA eLogbook Through a Theory of Change Framework.World journal of surgery · 2026Article
- Surgical Site Infections After Laparotomy in a Tertiary Referral Hospital in Kenya: Incidence and Risk Factors.World journal of surgery · 2026Article
- Optimizing the management of laparoscopic equipment in low-resource settings: a SAGES White Paper.Surgical endoscopy · 2026Article
- Operating Together: Challenges and Solutions for Sustaining Impactful Global Health Partnerships From 18 years of the RCSI/COSECSA Surgical Training Collaboration.World journal of surgery · 2026Article
- Current use of minimally invasive surgery in Ethiopia.Surgical endoscopy · 2026Article
- Minimally Invasive Surgical Techniques in the Treatment of Appendicitis: A Narrative Review.Cureus · 2025Review
- Advancing laparoscopic surgery in low- and middle-income countries (LMICs): pilot implementation of the Global Laparoscopic Advancement Program (GLAP) with Fundamentals of Laparoscopic Surgery (FLS) certification in Ethiopia.Surgical endoscopy · 2025Article
- Bridging the gap: feasibility and future directions of robotic surgery in Sub-Saharan Africa-a narrative review.Journal of robotic surgery · 2025Review
- A novel tool for assessing psychomotor proficiency in laparoscopic cholecystectomy using simulation-based training.Surgical endoscopy · 2025Article
- Laparoscopic appendectomy improves outcomes and reduces costs in rural Kenya.Surgical endoscopy · 2025Article
- Learning new surgical techniques in low and middle income countries, approval processes, and the impact of artificial intelligence.Frontiers in surgery · 2025Review
- Barriers to diffusion and implementation of pediatric minimally invasive surgery in Brazil.BMC medical education · 2024Article
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWith the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied.
methodsWe conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization.
resultsAmong 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001).
conclusionsThe study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques.
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