PMID- 35241280
OWN - NLM
STAT- MEDLINE
DCOM- 20220523
LR  - 20220523
IS  - 1531-5037 (Electronic)
IS  - 0022-3468 (Linking)
VI  - 57
IP  - 6
DP  - 2022 Jun
TI  - A novel low cost minimally invasive surgical system allows for the translation of 
      modern pediatric surgical technology to low- and middle-income nations.
PG  - 1099-1103
LID - S0022-3468(22)00099-9 [pii]
LID - 10.1016/j.jpedsurg.2022.01.027 [doi]
AB  - BACKGROUND: There is a critical need for pediatric surgical humanitarian care. 
      The role of minimally invasive surgery (MIS) in these environments with its 
      reduction in pain and wound care, operative time, length of hospitalization, and 
      morbidity is logical. However, the costs, logistics and feasibility of MIS in 
      Low- and Middle-Income Countries (LMIC) can be challenging. Our goal was to 
      develop a new low cost rapidly deployable minimally invasive surgical system 
      (RDMIS) for use during remote pediatric general surgical (GPS) missions in LMIC. 
      METHODS: RDMIS system components consist of a universal serial bus (USB) 
      interfaced laparoscopic camera, portable computer and a battery powered wireless 
      portable laparoscopic light source. The surgeon transports the RDMIS in a single 
      standard carry-on luggage. Utilizing prepositioning logistics from prior World 
      Pediatric GPS missions, a standard MIS tower system (sMIS) was maintained on 
      site. RESULTS: The RDMIS was utilized to carry out procedural components of 
      laparoscopic appendicostomy and laparoscopic cholecystectomy. Both sMIS and RDMIS 
      were interchanged during the cases to allow for subjective comparison of surgical 
      exposure and visualization. The RDMIS system allowed for safe and effective 
      visualization and dissection of surgical structures. All children recovered 
      uneventfully and were discharged the following day and have had no complications. 
      The RDMIS system costs were significantly less than those of sMIS. CONCLUSIONS: 
      RDMIS appears to be a safe, inexpensive option that will allow for the 
      translation of modern MIS technology during GPS in remote locations. Further 
      studies validating the RDMIS are indicated, however, the lower costs, ease of 
      transport and potential benefit to children in the LMIC may be significant.
CI  - Copyright (c) 2022. Published by Elsevier Inc.
FAU - Lukish, Jeffrey R
AU  - Lukish JR
AD  - Division of Pediatric Surgery, Children's National Hospital, Washington D.C., 
      USA; The Sheikh Zayed Institute for Pediatric Surgical Innovation, Washington 
      D.C, USA; George Washington University, Washington D.C, USA; Uniformed Services 
      University of the Health Sciences, Bethesda, MD, USA. Electronic address: 
      jlukish@childrensnational.org.
FAU - Ellis-Davy, Jasmine
AU  - Ellis-Davy J
AD  - Milton Kato Memorial Hospital, Saint Vincent and the Grenadines, West Indies.
LA  - eng
PT  - Journal Article
DEP - 20220201
PL  - United States
TA  - J Pediatr Surg
JT  - Journal of pediatric surgery
JID - 0052631
SB  - IM
MH  - Child
MH  - *Cholecystectomy, Laparoscopic
MH  - Humans
MH  - *Laparoscopy
MH  - Minimally Invasive Surgical Procedures
MH  - Operative Time
MH  - *Surgeons
MH  - Technology
OTO - NOTNLM
OT  - Global pediatric surgery
OT  - Humanitarian outreach
OT  - Minimally invasive surgery
EDAT- 2022/03/05 06:00
MHDA- 2022/05/24 06:00
CRDT- 2022/03/04 05:35
PHST- 2022/01/07 00:00 [received]
PHST- 2022/01/22 00:00 [accepted]
PHST- 2022/03/05 06:00 [pubmed]
PHST- 2022/05/24 06:00 [medline]
PHST- 2022/03/04 05:35 [entrez]
AID - S0022-3468(22)00099-9 [pii]
AID - 10.1016/j.jpedsurg.2022.01.027 [doi]
PST - ppublish
SO  - J Pediatr Surg. 2022 Jun;57(6):1099-1103. doi: 10.1016/j.jpedsurg.2022.01.027. 
      Epub 2022 Feb 1.