Advance laparoscopy in minimal resource settings of Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar.

Abstract

Objective: To share our experience of performing basic and advance laparoscopic procedures with minimal resources in a small trust hospital of Bhakkar. Study Design: Retrospective study. Setting: Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar. Period: 19^th April, 2020 to 11^th February, 2022. Methods: No new intervention was done. On admission to hospital, an informed consent was taken. Another informed consent prior to surgery was taken as well. All the cases were done by a single surgical team. All the procedures were done according to proper guidelines and regulations. Procedures were again divided into basic and advance laparoscopic procedures. Laparoscopic cholecystectomy, laparoscopic appendectomy and diagnostic laparoscopy were considered as basic laparoscopic procedures. All others were classified as advance ones. Types of procedure, conversion to open surgery, complications and outcomes were recorded. Results: In 22 months duration total 1152 laparoscopic surgeries were performed at Brig Shafique Ahmed Khan Niazi Memorial Trust Hospital, Bhakkar. About 752 were basic and 400 were advance. About 12 procedures were converted to open. The complication rate recorded was about 2%. Conclusion: Advance laparoscopic procedures can be safely performed in trust hospitals of lower middle income countries with limited resources.