Evaluating Safety and Efficiency of Laparoscopic General Surgery Techniques in Pakistan. A Retrospective Study

Background: The minimally invasive nature, reduced complications, and quick recovery of laparoscopic general surgery have changed the face of surgical practice around the world. However, the barriers, adoption of the technology is not widespread in low and middle-income countries (LMICs) such as Pakistan. Objectives: The objectives of present study were to assess the safety and efficiency of laparoscopic general surgery techniques in Pakistan. Methods: This retrospective study comprised 200 patients who were scheduled for elective laparoscopic surgeries (50%) cholecystectomy, (30%) appendectomy, and (20%) hernia repairs at tertiary care hospitals in Lahore, Pakistan from June 2022 to September 2023. Intraoperative and postoperative outcomes and predictors of complications were analyzed, and demographic data were analyzed. Logistic regression was used to identify significant predictors of statistical analysis performed using SPSS version 27. Results: The Patients were 45.6 ± 12.3 years old and had a mean BMI of 28.7 ± 3.4 kg/m². Eighty-five percent of the cases had intraoperative complications; bleeding (4%) was the most common. In 6.5% of cases, conversion to open surgery was noted. In 15%, postoperative complications were found, and wound infection (6%) and seroma formation (5%) were most frequent. Hospital stays were longer in patients with complications (5.5 ± 1.6 days, p<0.001). Logistic regression identified BMI >30 kg/m² (OR: 2. Operative time >90 minutes (OR: 2.6) and 1) as predictors of complications. Conclusion: Safety & efficiency outcomes of laparoscopic general surgery in Pakistan, comparable to global standards, are demonstrated. To further improve access and outcomes, targeted investments in training, infrastructure, and patient optimization are necessary.