Dan D, Naraynsingh V, Cawich S, Jonnalagadda R
Department of Surgery, The University of the West Indies, St Augustine, Trinidad and Tobago.
West Indian Med J. 2012 Jul;61(4):467-71. doi: 10.7727/wimj.2012.136.
The first world witnessed a laparoscopic revolution in the 1990s. At the start, laparoscopic surgery was heavily criticized and ridiculed. Despite this, the specialty has blossomed where almost any procedure can be done laparoscopically with the now obvious tremendous benefit to the patients. The objective of this paper is to examine where the Caribbean is placed relative to the rest of the world in terms of laparoscopic surgery and to understand why we are here.
The literature written on laparoscopy in the region was reviewed and contributions were taken from key surgeons in three main islands, Trinidad and Tobago, Barbados and Jamaica.
Though the first laparoscopic cholecystectomy in the Caribbean, in most islands, took place in the early 1990s like the rest of the world, there was relative dormancy for at least a decade in Trinidad and Tobago and even longer in other islands with regards to implementing advanced procedures or increasing case volumes. Reasons for this included lack of funding, lack of operating time in public facilities, lack of information of the public and the medical fraternity but most importantly lack of trained laparoscopic surgeons. This last factor was proven to be the key one in Trinidad and Tobago in 2003, Jamaica 2005 and Barbados 2011/12, when the return of trained personel engineered the transition from basic to advanced laparoscopy
Despite the delay of approximately 10 years in Trinidad and Tobago and 15 years in other islands, the return of trained surgeons has seen a rapid increase in case variety and volumes in laparoscopy. The wheels of motion of the laparoscopic revolution in the Caribbean have finally begun.
20世纪90年代，世界见证了腹腔镜技术的革命。起初，腹腔镜手术遭到了严厉批评和嘲笑。尽管如此，该专业还是蓬勃发展起来，如今几乎任何手术都可以通过腹腔镜进行，这对患者有着显而易见的巨大益处。本文的目的是研究加勒比地区在腹腔镜手术方面相对于世界其他地区的位置，并了解我们处于这种状况的原因。
回顾了该地区关于腹腔镜技术的文献，并收集了特立尼达和多巴哥、巴巴多斯以及牙买加这三个主要岛屿的关键外科医生的贡献。
尽管加勒比地区的首例腹腔镜胆囊切除术在大多数岛屿与世界其他地区一样发生在20世纪90年代初，但在特立尼达和多巴哥至少有十年处于相对停滞状态，而在其他岛屿，在实施先进手术或增加病例数量方面停滞的时间甚至更长。原因包括缺乏资金、公共设施中缺乏手术时间、公众和医学界缺乏信息，但最重要的是缺乏训练有素的腹腔镜外科医生。在2003年的特立尼达和多巴哥、2005年的牙买加以及2011/12年的巴巴多斯，这最后一个因素被证明是关键因素，当时训练有素的人员回归推动了从基础腹腔镜手术向先进腹腔镜手术的转变。
尽管特立尼达和多巴哥延迟了约10年，其他岛屿延迟了15年，但训练有素的外科医生的回归使得腹腔镜手术的病例种类和数量迅速增加。加勒比地区腹腔镜技术革命的车轮终于开始转动了。
