Scalable Low-cost Laparoscopic Cholecystectomy: Bridging The Surgical Gap In Low-resource Settings

Scalable Low-cost Laparoscopic Cholecystectomy: Bridging The Surgical Gap In Low-resource Settings

Martin Rodriguez Alvarado , Jaír Ariel A Nava Vázquez, Alan M Solís Velázquez, Sofía R Adame, Jack Abadi Chiriti, Ramón A Magaña Dávalos, Diego I Díaz Haaz
Instituto Politecnico Nacional, Ciudad de México, Mexico; Centro Médico ABC, Ciudad de México, Mexico

Background:
Laparoscopic cholecystectomy is the gold standard for gallbladder removal, offering reduced morbidity, shorter hospital stays, and faster recovery. However, its implementation in low- and middle-income countries (LMICs) is hindered by high equipment costs, limited technical expertise, and infrastructure gaps. This study presents an innovative, cost-effective laparoscopic approach using locally available resources, aiming to make minimally invasive surgery (MIS) accessible and sustainable in resource-limited settings.

Methods:
A prospective pilot study was conducted in a regional hospital with limited surgical infrastructure. A modified laparoscopic technique was implemented using affordable, reusable trocars, cost-efficient LED light sources, and adapted laparoscopic instruments. Surgeons underwent a short-term, targeted training program. Key outcomes assessed included operative time, postoperative pain (VAS scores), complication rates, hospital stay duration, and cost-effectiveness, compared to conventional open cholecystectomy.

Results:
Among 120.00 patients, the modified laparoscopic approach demonstrated a 20% reduction in operative time (60 vs. 75.00 minutes, p=0.03), a 50% decrease in pain scores (VAS 3.20 vs. 6.8, p<0.001), and a 65% shorter hospital stay (1.5 vs. 4.30 days, p<0.001). The complication rate remained comparable to standard laparoscopic procedures (7.5%). Notably, procedural costs were reduced by 50% compared to conventional laparoscopic systems, significantly enhancing the feasibility of MIS adoption in LMICs.

Conclusion:
This study provides a replicable and scalable solution for integrating laparoscopic surgery into low-resource settings. By reducing costs and optimizing training, this approach has the potential to bridge the global surgical gap, improve patient outcomes, and redefine the landscape of surgical care in LMICs. Further research is needed to assess long-term outcomes and broader implementation strategies.

Keywords: Low-Cost Laparoscopy, Minimally Invasive Surgery, Global Surgery, Surgical Accessibility, Low-Resource Settings, Cost-Effective Innovations