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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Barriers to the uptake of laparoscopic surgery in a lower-middle-income country
Surgical Endoscopy, Volume 27, No. 11, Year 2013
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Description
Background Despite the significant improvements in surgical care in developed countries, the adoption of laparoscopy in lower-middle-income countries (LMICs) has been sporadic and minimal. Although the most quoted explanation for this has been an apparent lack of resources and training, recent studies have demonstrated that these constraints may not be the only significant barrier. The overall aim of this study was to analyze barriers to the adoption of laparoscopic surgery at a hospital in an LMIC. Methods Using an exploratory case study design, this investigation identified barriers to the adoption of laparoscopic surgery in an LMIC. More than 600 hours of participant observation as well as 13 in-depth interviews and document analyses were collected over a 12-week period. Results Three overarching barriers emerged from the data: (1) the organizational structure for funding laparoscopic procedures, (2) the hierarchical nature of the local surgical culture, and (3) the expertise and skills associated with a change in practice. The description of the first barrier shows how the ongoing funding structure, rather than upfront costs, of the laparoscopic program limited the number of laparoscopic cases. The description of the second barrier highlights the importance of understanding the local surgical culture in attempts to adopt new technology. The description of the third barrier emphasizes the fact that due to the generalist nature of surgical practice, surgeons were less willing to practice more technically complicated and time-consuming procedures. Conclusion This exploratory case study examining the barriers hindering the adoption of laparoscopy in an LMIC represents a novel approach to addressing issues that have plagued surgeons across LMICs for many years. These findings not only further understanding of how to improve the adoption of laparoscopy in LMICs but also challenge the economic-centric notions of the problems that affect the transfer of innovation across social, economic, and geographic boundaries. © Springer Science+Business Media New York 2013.
Authors & Co-Authors
Choy, Ian
Canada, Toronto
University of Toronto
Canada, Toronto
Temerty/chang International Centre for Telesimulation and Innovation in Medical Education
Kitto, Simon
Canada, Toronto
University of Toronto
Canada, Toronto
Li ka Shing Knowledge Institute
Adu-Aryee, Nii Armah
Ghana, Accra
Korle bu Teaching Hospital
Okrainec, Allan
Canada, Toronto
Temerty/chang International Centre for Telesimulation and Innovation in Medical Education
Canada, Toronto
Toronto Western Hospital University of Toronto
Statistics
Citations: 87
Authors: 4
Affiliations: 5
Identifiers
Doi:
10.1007/s00464-013-3019-z
ISSN:
09302794
e-ISSN:
14322218
Research Areas
Health System And Policy
Study Design
Exploratory Study
Ethnographic Study
Case Study
Study Approach
Qualitative