Laparoscopy in Rwanda: A National Assessment of Utilization, Demands, and Perceived Challenges

dc.contributor.authorRobertson, Faith
dc.contributor.authorMutabazi, Zeta
dc.contributor.authorKyamanywa, Patrick
dc.contributor.authorNtakiyiruta, Georges
dc.contributor.authorMusafiri, Sanctus
dc.contributor.authorWalker, Tim
dc.contributor.authorKayibanda, Emmanuel
dc.contributor.authorMukabatsinda, Constance
dc.contributor.authorScott, John
dc.contributor.authorCostas-Chavarri, Ainhoa
dc.date.accessioned2018-09-26T07:11:29Z
dc.date.available2018-09-26T07:11:29Z
dc.date.issued2018-09-19
dc.descriptionArticle available full texten_US
dc.description.abstractBackground Laparoscopy has proven to be feasible and effective at reducing surgical morbidity and mortality in low resource settings. In Rwanda, the demand for and perceived challenges to laparoscopy use remain unclear. Methods A mixed-methods study was performed at the four Rwandan national referral teaching hospitals. Retrospective logbook reviews (July 2014–June 2015) assessed procedure volume and staff involvement. Web-based surveys and semi-structured interviews investigated barriers to laparoscopy expansion. Results During the study period, 209 laparoscopic procedures were completed: 57 (27.3%) general surgery cases; 152 (72.7%) ob/gyn cases. The majority (58.9%, 125/209) occurred at the private hospital, which performed 82.6% of cholecystectomies laparoscopically (38/46). The three public hospitals, respectively, performed 25% (7/28), 15% (12/80), and 0% (denominator indeterminate) of cholecystectomies laparoscopically. Notably, the two hospitals with the highest laparoscopy volume relied on a single surgeon for more than 85% of cases. The four ob/gyn departments performed between 4 and 87 laparoscopic cases (mostly diagnostic). Survey respondents at all sites listed a dearth of trainers as the most significant barrier to performing laparoscopy (65.7%; 23/35). Other obstacles included limited access to training equipment and courses. Equipment and material costs, equipment functionality, and material supply were perceived as lesser barriers. Twenty-two interviews revealed widespread interest in laparoscopy, insufficient laparoscopy exposure, and a need for trainers. Conclusion While many studies identify cost as the most prohibitive barrier to laparoscopy utilization in low resource settings,logbook review and workforce perception indicate that a paucity of trainers is currently the greatest obstacle in Rwanda.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12306/1329
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.subjectLaparoscopyen_US
dc.subjectLaparoscopic surgeryen_US
dc.subjectChallenges to laparoscopy useen_US
dc.subjectLaparoscopy utilizationen_US
dc.subjectDemanden_US
dc.subjectPerspective Challengesen_US
dc.subjectLaparoscopy expansionen_US
dc.subjectRwandaen_US
dc.titleLaparoscopy in Rwanda: A National Assessment of Utilization, Demands, and Perceived Challengesen_US
dc.typeArticleen_US
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