Expanding Laparoscopic Cholecystectomy to Rural Mongolia

Straub, Catherine M.; Price, Raymond R.; Matthews, Douglas; Handrahan, Diana; Sergelen, Davaatseren

doi:10.1007/s00268-011-0965-2

Cited by 27 publications

(53 citation statements)

References 10 publications

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“…Complication and conversion rates in Mongolia are consistent with those seen at the inception of laparoscopy in the 1990s. 5 One might expect the complication rate to be elevated during the practical portion of the training period where surgeons learning laparoscopy have not had previous experience. However, the common bile duct injury rate and bowel injury rate thus far has been extremely low during the 303 laparoscopic cholecystectomy cases performed.…”

Section: Discussionmentioning

confidence: 99%

“…An initial report of complication and conversion rates in Ulaanbataar and Erdenet indicated acceptable rates following the trainings. 5 The multidisciplinary team approach, teaching comprehensive surgical care (pre-, intra-, and postoperative care), and introducing twice daily team rounds with surgery, anesthesia, and nursing was one of the features most appreciated by our hosts. A significant amount of time was spent discussing and reviewing the appropriate work-up and selection of patients for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic cholecystectomy was first introduced into Mongolia in 1994, but by 2005 only 2% of the gallbladders were being removed laparoscopically, and no laparoscopy was performed outside of the capital city, Ulaanbataar. 4,5 The epidemiology of diseases in Mongolia has dramatically changed over the last 3 decades. Where echinococcal disease was one of the leading surgical diagnoses in the early 1960s, it is now uncommon.…”

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confidence: 99%

“…This article reviews the teaching methods and important concepts learned over the last 5 years in expanding laparoscopy in a sustainable manner throughout Mongolia. 5 …”

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confidence: 99%

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A Successful Model for Laparoscopic Training in Mongolia

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Sergelen

et al. 2013

International Surgery

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The benefits of laparoscopic surgery have not been available to the majority of Mongolians. Mongolian surgical leaders requested assistance in expanding laparoscopy. A capacity-building approach for teaching laparoscopic cholecystectomy throughout Mongolia is reviewed. A laparoscopic cholecystectomy training program was developed. The program included a didactic course and an intensive 2-week practical operating experience. Courses were taught in Ulaanbataar and at 3 of the 4 regional diagnostic referral and treatment centers from 2006 to 2010. During this training period, a total of 303 teaching laparoscopic cholecystectomies were performed. There was one common bile duct injury and one duodenal injury. The conversion rate was 2.0%. This program has been successful in creating a self-sustaining practice of training. The traditional surgical approach to gallbladder disease in Mongolia has been challenged and has, in turn, been a stimulus for improvement in the medical community.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…This article reviews the teaching methods and important concepts learned over the last 5 years in expanding laparoscopy in a sustainable manner throughout Mongolia. 5 …”

mentioning

confidence: 99%

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A Successful Model for Laparoscopic Training in Mongolia

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Sergelen

et al. 2013

International Surgery

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“…1,2 There is debate as to the wisdom of introducing techniques involving minimal access surgery (MAS) of any type into LMIC when the open alternative is safe and cost-effective. [2][3][4][5] The initial and ongoing costs to operate MAS programs in LMIC may be prohibitive, [3][4][5] but many feel that the benefits reported in the HIC experience may justify these costs.…”

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confidence: 99%

Establishing a Contextually Appropriate Laparoscopic Program in Resource-restricted Environments

et al. 2015

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A contextually appropriate long-term partnership may assist with laparoscopic upskilling of colleagues in low- and middle-income countries. This type of collaboration promotes local ownership and may translate into better patient outcomes associated with laparoscopic surgery. In resource-restricted environments, the factors threatening sustainability may differ from those in high-income countries and should be identified and addressed.

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Improving Surgical Care in Mongolia: A Model for Sustainable Development

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Unursaikhan³

2012

World j. surg.

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The W. C. Swanson Family Foundation selected Mongolia to help improve access to affordable quality surgical and medical care in 2000. Over the last 12 years of partnering with the Health Sciences University of Mongolia, three major concepts have been identified that have promoted sustainable progress in expanding and improving surgical care throughout the healthcare system-including urban and rural areas. Understanding and targeting the needs identified by the Mongolian surgical community has cultivated a critical working environment that has had a profound effect on expanding surgical care in Mongolia. Integrating modern surgical care training with basic emergency and essential surgical and medical initiatives created a trusting foundation providing many unforeseen educational opportunities. Lastly, the educational model introduced, including long-term capacity-building programs, has helped enable the local Mongolian surgeons, nurses, biotechnicians, administrators, and educators to continue pioneering independent efforts to further expand modern surgical care in Mongolia.

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Expanding Laparoscopic Cholecystectomy to Rural Mongolia

Abstract: Laparoscopic cholecystectomy can be expanded safely to the regional diagnostic referral centers in rural Mongolia through short-term training courses as a method to markedly improve access and outcomes for the 50% of the country previously denied the benefits of minimally invasive surgery.

Cited by 27 publications

References 10 publications

A Successful Model for Laparoscopic Training in Mongolia

A Successful Model for Laparoscopic Training in Mongolia

Establishing a Contextually Appropriate Laparoscopic Program in Resource-restricted Environments

Improving Surgical Care in Mongolia: A Model for Sustainable Development

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