Investigating the barriers to the development of laparoscopic surgery in Haiti

Minimally invasive surgery has become a routine procedure in many countries. This is not the case in Haiti despite basic laparoscopic equipment being available in several hospitals and surgeons receiving training in this surgical practice. This study aims to investigate the barriers to the development of laparoscopy in Haiti, as perceived by active Haitian surgeons.

A country-wide audit was conducted in Haiti to determine hospitals where functioning laparoscopic equipment was available. A sample of general and pediatric surgeons were interviewed using semi-structured interviews to examine their perceived barriers to laparoscopic surgery. Interviews were transcribed and analyzed using thematic analysis.

Ten surgeons were interviewed. Very few of them reported regularly performing laparoscopic procedures, despite having received past training and having equipment available. Major barriers attributed to limiting the growth of laparoscopy in Haiti include the high out-of-pocket cost for patients, lack of patient understanding of the procedure, shortage of reliable equipment and supplies, and inadequate training. Other barriers identified by the study participants include the reluctance of senior surgeons to adopt new practices and share knowledge with peers.

The laparoscopic equipment available to Haitian surgeons and the training offered to them are insufficient to practice laparoscopic surgery on a consistent basis. Increasing access to laparoscopic surgery will require lowering the cost to patients, establishing a reliable supply chain, and patient education. It may also be beneficial to consolidate laparoscopic centers to improve knowledge, training, and reliable access.