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Improving Access to Laparoscopic Surgery in Low- and Middle-Income Countries

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1 Credit CME

There is a strong desire by surgeons and patients in low- and middle-income countries (LMICs) to access laparoscopic surgery. However, access is hindered by high installation costs, fragile equipment maintenance, lack of stable electricity, and limited consumable items such as medical-grade carbon dioxide. Using the human-centered design approach,1 our multidisciplinary team of surgeons, engineers, and global health researchers has developed a low-cost laparoscope (KeyScope) and lift retractor (KeyLoop), collectively referred to as KeySuite, designed for the challenges and needs of LMICs.

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Article Information

Corresponding Author: Siddhesh Zadey, BSMS, MScGH, Department of Surgery, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 27710 (siddhesh.zadey@duke.edu).

Published Online: July 20, 2022. doi:10.1001/jamasurg.2022.2675

Conflict of Interest Disclosures: Dr Mueller reported grants from the National Institutes of Health during the conduct of the study and personal fees from Calla Health Foundation outside the submitted work. Dr Fitzgerald reported grants from National Institutes of Health, Duke/Duke-NUS Pilot Project Grant, and Bass Connections at Duke University during the conduct of the study. Drs Fitzgerald and Mueller have PCT patent applications for the KeyScope and KeyLoop. No other disclosures were reported.

Funding/Support: This project has been funded by Bass Connections at Duke University, Duke/Duke-NUS Collaboration Pilot Project, and the National Institutes of Health (grant R21 CA249696-01A1).

Role of the Funder/Sponsor: The funders had no role in the preparation, review, or approval of the manuscript and decision to submit the manuscript for publication.

References
1.
Design Kit. The Field Guide to Human-Centered Design. Accessed June 10, 2022. https://www.designkit.org/resources/1
2.
Mueller  JL , Rozman  N , Sunassee  ED ,  et al.  An accessible laparoscope for surgery in low- and middle- income countries.   Ann Biomed Eng. 2021;49(7):1657-1669. doi:10.1007/s10439-020-02707-6PubMedGoogle ScholarCrossref
3.
Gupta  A , Brown  E , Davis  JT ,  et al.  KeyLoop: mechanical retraction of the abdominal wall for gasless laparoscopy.   Surg Innov. 2022;29(1):88-97. doi:10.1177/15533506211031084PubMedGoogle ScholarCrossref
4.
Xenocor. Accessed March 5, 2022. https://xenocor.com/
5.
Chao  TE , Mandigo  M , Opoku-Anane  J , Maine  R .  Systematic review of laparoscopic surgery in low- and middle-income countries: benefits, challenges, and strategies.   Surg Endosc. 2016;30(1):1-10. doi:10.1007/s00464-015-4201-2PubMedGoogle ScholarCrossref
6.
Alganabi  M , Biouss  G , Pierro  A .  Surgical site infection after open and laparoscopic surgery in children: a systematic review and meta-analysis.   Pediatr Surg Int. 2021;37(8):973-981. doi:10.1007/s00383-021-04911-4PubMedGoogle ScholarCrossref
7.
Farrow  NE , Commander  SJ , Reed  CR ,  et al.  Laparoscopic experience and attitudes toward a low-cost laparoscopic system among surgeons in East, Central, and Southern Africa: a survey study.   Surg Endosc. 2021;35(12):6539-6548. doi:10.1007/s00464-020-08151-wPubMedGoogle ScholarCrossref
8.
Mishra  A , Bains  L , Jesudin  G ,  et al.  Evaluation of gasless laparoscopy as a tool for minimal access surgery in low-to middle-income countries: a phase II noninferiority randomized controlled study.   J Am Coll Surg. 2020;231(5):511-519. doi:10.1016/j.jamcollsurg.2020.07.783PubMedGoogle ScholarCrossref
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