Evidence map›Paper›PMID 40674795›Full record

ArticleThe Journal of surgical research2025

Global Utilization of Minimally Invasive Surgery: Practice and Challenges.

Olivia C McGinnis, Anne S Wesonga, Hizuru Amano, Amos Loh, Arushi Biswas, Pierce Hollier, Robert T Ssekitoleko, Jenna L Mueller, Tamara N Fitzgerald

Abstract read
In one paragraph

Article in The Journal of surgical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

9 authors.

Olivia C McGinnisDepartment of Surgery, Duke University School of Medicine, Durham, North Carolina. Electronic address: Olivia.kapera@duke.edu.
Anne S WesongaMulago Hospital, Kampala, Uganda.
Hizuru AmanoDepartment of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Amos LohSingHealth Duke-NUS Global Health Institute, Duke-NUS Medical School, Singapore.
Arushi BiswasThe John Hopkins School of Medicine, Baltimore, Maryland.
Pierce HollierUniversity of Texas Southwestern Medical Center, Dallas, Texas.
Robert T SsekitolekoBiomedical Engineering Unit, Department of Physiology, School of Biomedical Sciences, College of Health Science, Makerere University College of Health Science, Kampala, Uganda.
Jenna L MuellerDepartment of Bioengineering, University of Maryland, College Park, Maryland.
Tamara N FitzgeraldDepartment of Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Global Health Institute, Durham, North Carolina.

Funding

Unlocking the Economics of Cancer Control in Uganda Using KeyScopeU01CA269190 · NCI · DUKE UNIVERSITY · PI TAMARA N FITZGERALD · 2022 to 2026
$2.5M
Increasing Accessibility of Laparoscopic Surgery in Low- and Middle-Income CountriesR21CA249696 · NCI · DUKE UNIVERSITY · PI FITZGERALD, TAMARA N · 2021 to 2022
$407k
NCI NIH HHS R21 CA249696NCI NIH HHS U01 CA269190
6 · The paper itself

Abstract

introductionUptake of minimally invasive surgery (MIS) in low- and middle-income countries (LMICs) has been slow due to various barriers. This study examined the experiences of surgeons across multiple countries, highlighting the complications and challenges that arise with MIS.

methodsForty-one surgeons from Japan, Singapore, Uganda, the United States, Cambodia, Vietnam, and Malaysia completed 12-question surveys detailing the challenges of their MIS cases. Data were collected from April 2021 to February 2023, and descriptive statistics were generated.

resultsA total of 198 MIS cases were reported by 36 surgeons during the study period. In LMICs, patients tended to be older (P < 0.001), more likely to be female (P < 0.001), and have fewer comorbidities (P < 0.01) than in high-income countries (HICs). Antireflux procedures, appendectomies, and cholecystectomies were the most common MIS performed. Surgical assistants varied, with Japanese surgeons reporting the highest usage of experienced surgeons as assistants (n = 53, 56%). Minimal blood loss was perceived for 80% of cases in HICs (n = 99), whereas greater than minimal blood loss was perceived in LMICs (n = 41, 55%; P < 0.001). While most HIC surgeons found cases easy (n = 93, 75%) with no technical challenges, a higher percentage of LMIC surgeons considered converting to open procedures (n = 5, 7%) or had to convert (n = 6, 8%; P < 0.001). Thematic grouping identified four key barriers in LMICs: access to resources, maintenance of equipment, difficult intraoperative pathology, and surgical training availability.

conclusionsThis study highlights significant differences in the MIS experience between HICs and LMICs. Technical difficulties and intraoperative challenges were more frequent in LMICs, and all cases converted to open procedures originated from these regions. The identified barriers-access to resources, equipment maintenance, difficult intraoperative pathology, and surgical training-are critical areas that need targeted interventions.

Indexed as

Minimally Invasive Surgical ProceduresPractice Patterns, Physicians'SurgeonsAdultDeveloping CountriesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesClinical challengesCost-effective solutionsGlobal surgeryHealth care accessLaparoscopyMinimally invasive surgerySurgical outcomesSurgical training

Identifiers

PMID40674795
PMCPMC12326319

What OpenQuestion holds

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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.