Scaling Laparoscopic Surgery in LMICs: Barriers, innovations and Policy Recommendations.
Tags : Global SurgeryHealth PolicyHealth Systems StrengtheningInfrastructure ChallengesLaparoscopic SurgeryLMICsMinimally Invasive SurgeryOriginal ResearchPolicy RecommendationsSurgical Capacity BuildingSurgical EquitySurgical InnovationSystematic ReviewTechnology AdoptionThe Operating Room GlobalThe Operating Room Global JournalTORGJWorkforce Training
Article DOI: https://doi.org/10.64573/torgj2507007
Authors: Oluwatobiloba O. Aweda1* Emmanuel Abiodun Owolabi1 Olorunwa Barnabas Alalade1
| 1Benjamin Carson (Snr) College of Health and Medical Sciences, Babcock University, Ogun State, Nigeria. |
Cite:
- APA (7th edition): Aweda, O. O., Owolabi, E. A., & Alalade, O. B. (2025, November 21). Scaling laparoscopic surgery in LMICs: Barriers, innovations and policy recommendations. The Operating Room Global Journal (TORGJ), 1(1). https://doi.org/10.64573/torgj2507007
- Harvard: Aweda, O.O., Owolabi, E.A. and Alalade, O.B., 2025. Scaling laparoscopic surgery in LMICs: Barriers, innovations and policy recommendations. The Operating Room Global Journal (TORGJ), 1(1), Published 21 November. Available at: https://doi.org/10.64573/torgj2507007
- Vancouver: Aweda OO, Owolabi EA, Alalade OB. Scaling laparoscopic surgery in LMICs: Barriers, innovations and policy recommendations. The Operating Room Global Journal (TORGJ). 2025 Nov 21;1(1). https://doi.org/10.64573/torgj2507007
- MLA (9th edition): WAweda, Oluwatobiloba O., Emmanuel Abiodun Owolabi, and Olorunwa Barnabas Alalade. “Scaling Laparoscopic Surgery in LMICs: Barriers, Innovations and Policy Recommendations.” The Operating Room Global Journal (TORGJ), vol. 1, no. 1, 21 Nov. 2025, https://doi.org/10.64573/torgj2507007
- Chicago (Author–Date): Aweda, Oluwatobiloba O., Emmanuel Abiodun Owolabi, and Olorunwa Barnabas Alalade. 2025. “Scaling Laparoscopic Surgery in LMICs: Barriers, Innovations and Policy Recommendations.” The Operating Room Global Journal (TORGJ) 1 (1), November 21. https://doi.org/10.64573/torgj2507007
Corresponding Author*:
Oluwatobiloba O. Aweda
[email protected]
Declaration:
Authors’ Contribution:
Oluwatobiloba O. Aweda conceptualized the study and led the writing process. Emmanuel A. Owolabi contributed to the literature review and drafting. Olorunwa B. Alalade participated in data synthesis and critical revisions. All authors reviewed and approved the final manuscript.
Conflict of Interest:
No conflict of interest.
Funding:
No funding received by the authors
| Article History: |
| Received: 15-07-2025 Accepted: 18-10-2025 |
| Available Online: 21-11-2025 |
| QR Code Access to this Article |
| ABSTRACT |
| Background: Laparoscopic surgery has transformed surgical care by reducing morbidity, shortening hospital stays, and improving recovery. However, its adoption in low- and middle-income countries remains limited. Objective: This article assesses the current landscape, challenges, and enablers of laparoscopic surgery in LMICs and provides policy and research recommendations for sustainable expansion. Methods: A narrative review was conducted across PubMed, Embase, Google Scholar, and institutional/grey literature sources for English-language records between January 2013 and March 2024. Search terms included: (“laparoscopic surgery” OR “minimally invasive surgery” OR “MIS”) AND (“low- and middle-income” OR “LMIC” OR “developing country”) AND (“training” OR “cost” OR “barrier” OR “implementation”). Titles/abstracts and full texts were screened independently by two reviewers, with discrepancies resolved by consensus. A total of 78 articles met the inclusion criteria. Themes were synthesized using an iterative thematic analysis. Results: Key barriers identified were limited infrastructure (reported in about 75% of included studies), inadequate training programs (62%), and high equipment costs (65%). Cultural resistance. Ongoing initiatives for locally manufactured or refurbished laparoscopic equipment are emerging in regions like Nigeria and India, helping to mitigate cost barriers. Cultural resistance and weak financing mechanisms were also noted. Promising enablers included low-cost laparoscopic kits, mobile simulation platforms, and NGO-supported programs. Evidence gaps persist in cost-effectiveness research, comparative evaluation of training models, and assessment of policy interventions. Conclusion: Scaling up laparoscopic surgery in LMICs is an urgent priority. Targeted investments, supportive policies, and cultural engagement are essential to overcome barriers. Closing knowledge gaps and embedding laparoscopic techniques into national surgical plans will reduce disparities and strengthen surgical systems in resource-limited settings. Keywords: Global Surgery, Healthcare Policy, Laparoscopic Surgery, Low and Middle-Income Countries (LMICs), Minimally Invasive Surgery (MIS), Surgical Training, Policy Implementation, Capacity Building. |
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