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- Title
The Responsible Use of Minimally Invasive Surgery in Remote Areas of Brazil: Feasibility and Safety of a Temporary Gynecologic Operative Expedition.
- Authors
Favero, Giovanni; Carvalho, Luiz Fernando; Barbosa, Thaisa Silveira; Valente, Cristina; Macerox, Nathalia; Barbosa, Priscila; Pfiffer, Tatiana; Kho, Rosanne; Baracat, Edmund Chada; Project, Bandeira Científica; Abrão, Maurício Simões
- Abstract
Objective: To evaluate the feasibility and safety of a novel model for providing minimally invasive surgical (MIS) care to underserved populations. Design: A prospective pilot study with patients affected by diverse benign pathologies of the female urogenital tract undergoing MIS in the context of a temporary expedition. Methods: In 2013, the Bandeira Científica Project implemented the use of MIS in one of the most underserved areas of Brazil. Results: During 4 days, 54 different procedures were performed on a cohort of 30 selected women. The mean age of the patients was 44.5 years (SD 8.3), while body mass index averaged 28.4 kg/m2 (SD 4.3). The primary indications for surgery were as follows: 14 symptomatic uterine leiomyomatosis/adenomyosis, 6 stress urinary incontinence, 6 endometriosis, and 4 pelvic floor defects. Forty percent of the patients underwent laparoscopy, 53% vaginal surgery, and 7% combined procedures. The mean estimated blood loss and operative time were 148 cc (0-1000) and 94 (24-180) minutes, respectively. No casualty or conversion to laparotomy occurred. The median hospital stay was 1 day (1-2). Significant complications occurred in two cases (6%); one postoperative bleeding and one pelvic infection. A satisfaction survey revealed that 100% of the participants were very satisfied. Conclusion: This series demonstrates that it may be feasible and secure to establish temporary MIS services in remote/distant locations. The correct selection of local facilities allied to the provision of modern equipment and experienced surgeons is essential to guarantee safety for patients. (J GYNECOL SURG 31:255)
- Subjects
BRAZIL; ENDOMETRIOSIS; MINIMALLY invasive procedures; GYNECOLOGIC surgery; PATIENT safety; PELVIC inflammatory disease; RURAL conditions; URINARY incontinence; PILOT projects; PELVIC floor injuries
- Publication
Journal of Gynecologic Surgery, 2015, Vol 31, Issue 5, p255
- ISSN
1042-4067
- Publication type
Article
- DOI
10.1089/gyn.2014.0141