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. 2021 Jul;51(3):408-414.
doi: 10.1177/0049475521998186. Epub 2021 Apr 13.

Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review

Ellen Wilkinson  1 , Noel Aruparayil  2 , J Gnanaraj  3 , Julia Brown  4 , David Jayne  2
Affiliations

Barriers to training in laparoscopic surgery in low- and middle-income countries: A systematic review

Ellen Wilkinson et al. Trop Doct. 2021 Jul.

Abstract

Laparoscopic surgery has the potential to improve care in resource-deprived low- and-middle-income countries (LMICs). This study aims to analyse the barriers to training in laparoscopic surgery in LMICs. Medline, Embase, Global Health and Web of Science were searched using 'LMIC', 'Laparoscopy' and 'Training'. Two researchers screened results with mutual agreement. Included papers were in English, focused on abdominal laparoscopy and training in LMICs. PRISMA guidelines were followed; 2992 records were screened, and 86 full-text articles reviewed to give 26 key papers. Thematic grouping identified seven key barriers: funding; availability and maintenance of equipment; local access to experienced laparoscopic trainers; stakeholder dynamics; lack of knowledge on effective training curricula; surgical departmental structure and practical opportunities for trainees. In low-resource settings, technological advances may offer low-cost solutions in the successful implementation of laparoscopic training and improve access to surgical care.

Keywords: LMIC; Laparoscopy; training.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram summarising search and screening strategy, based on PRISMA flow diagram.
See this image and copyright information in PMC

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