Current use of minimally invasive surgery in Ethiopia

Minimally invasive surgery (MIS) is recognized as a safe procedure with reduced postoperative patient morbidity compared to conventional surgical approaches. Its advantages, including shorter postoperative hospital stays and lower rates of wound infections, may be particularly beneficial for low- and middle-income countries. This study aimed to evaluate the current utilization of MIS and the challenges associated with its implementation across multiple sites in Ethiopia.

This cross-sectional study employed a structured questionnaire administered to surgeons and surgical residents via an online open-source data collection platform, KoBoToolbox, between August 13 and 28, 2023. The Surgical Society of Ethiopia's social media platform and Blue Health Medical Consultancy's registry were used to identify participants. The study utilized a voluntary response sampling method. Descriptive statistics were calculated.

Forty-eight surgeons and surgical residents from 25 different hospitals participated in this study. The mean age of the participants was 34 (SD ± 5) years with a male-to-female ratio of 11:1. MIS was available in 13 of the 25 (52%) hospitals with 8 (61%) of these hospitals situated in the capital, Addis Ababa. Only 19 out of 48 (40%) participants reported ever performing MIS procedures. The mean length of MIS practice was 3.6 years (SD ± 3.7). The most commonly performed MIS procedures were laparoscopic cholecystectomy (72%), laparoscopic appendectomy (56%), and laparoscopic hernioplasty (33%). The most commonly reported challenges associated with MIS were shortage of basic supplies (88% of respondents), inadequately trained operation theatre staff (88%), lack of biomedical engineering capacity (78%), and absence of local vendors for equipment (72%).

The utilization of MIS in Ethiopia is still in its early stages, with a majority of the practice concentrated in Addis Ababa. There are opportunities to assist the expansion of MIS via training and building support systems for supply chain and equipment maintenance.