Laparoscopic surgery in middle- and low-income countries: gasless lift laparoscopic surgery.
BACKGROUND
Surgically treatable conditions are an increasing burden in low- and middle-income countries, and recent studies suggest they have overtaken the "big three" (malaria, tuberculosis and HIV) as a cause of mortality.


OBJECTIVE
In this context, we have worked to modify standard laparoscopic equipment to allow laparoscopy in remote areas without support services such as bottled gases or disposable instruments.


RESULTS
A simple and reliable system of gasless laparoscopy has been developed using robust reusable instruments, widening the potential availability of laparoscopic surgery in remote and rural areas.


CONCLUSIONS
Our findings suggest that, using this equipment, appropriately trained surgeons can provide minimally invasive surgery in even the most remote locations.
SEESHA Ministries, Surgical Services Intiative, Coimbatore, India.
J
J
Gnanaraj
Honorary Reader in Surgery, University of East Anglia, Norwich, UK. mr@lapsurgeon.co.uk.|Department of Surgery, Musgrove Park Hospital, Taunton, Somerset, UK. mr@lapsurgeon.co.uk.
M
M
Rhodes
D003362:Cost-Benefit Analysis; D004867:Equipment Design; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes / Q000191:economics*; D010535:Laparoscopy / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D061646:Operative Time; D011184:Postoperative Period
CO2; General < technical; Instruments < technical; Surgical < technical