8 November 2017

Rwanda Looks to Promote Minimally Invasive Surgery to Save More Lives

A minimally invasive surgery is being introduced in Rwandan hospitals, and experts say it allows for quicker recovery than conventional surgery.

Minimally invasive surgery, also called laparoscopic surgery, is becoming more and more common in hospitals. These procedures are performed through tiny incisions instead of one large opening.

Experts show that because these incisions are small, patients tend to have quicker recovery times and less discomfort than with conventional surgery.

During a minimally invasive procedure, surgeons make several small incisions in the skin, just a few millimeters, in some cases. A long, thin tube with a miniature camera attached at the end (called an endoscope) is passed through one of the incisions.

According to Dr Jacob Souopgui, chair of Lab of Embryology and Biotechnology Charleroi Campus, in Belgium, images from the endoscope are projected onto monitors in the operating room so surgeons can get a clear (and magnified) view of the surgical area.

"Special instruments are passed through the other openings. The instruments allow the surgeon to perform the surgery by exploring, removing, or repairing whatever is wrong inside the body," he said.

Souopgui is one of the people pushing for adoption of minimally invasive surgery in Rwanda.

"I had the privilege of meeting President Kagame when I attended Rwanda Day in Belgium (this year). When they were discussing the issue of Africans seeking services abroad, I told him that I had an idea that I thought would solve some of the challenges faced by many Africans," he said.

"This was a proposal to implement minimally invasive surgery in the country to reduce the number of people who were travelling abroad to seek quality medical services. He accepted and told me to come to Rwanda."

Souopgui said many Africans spend millions of francs to get services abroad that would be saved if African governments can support the existing ideas.

Just a few months ago, the professor brought a team of specialised doctors from Belgium to perform a demonstration on the use of minimally invasive surgery in Kigali. The aim was to carry out a test of how the theatre was prepared, but Souopgoui said they ended up carrying out safe operations for 23 patients.

Claudine Tuyisenge, one of the patients who benefited from the minimally invasive surgery, had spent nearly 13 years with a vein complication and she had previously gone through two operations.

"I had an operation in 2006 and again in 2012, but nothing was working for me. When the Belgian team came to conduct the minimally invasive technology, it was quick and that was the end of the complication," she said.

Future of laparoscopic surgery

Tuyisenge said that she spent less than four hours in theatre and after two days, she had started working.

"With the past operations, I would spend two weeks at the hospital and another month without working. But with this procedure, I spent less than four hours and after two days I was back on my feet," she says.

According to a report on laparoscopic devices, recently released by Global Industry Analysts, 7.5 million laparoscopies were performed worldwide in 2015. For a number of operations such as appendectomy, tubal ligation, more than 90 per cent of interventions are now performed through minimally invasive approaches, with projected growth rates of up to 15 per cent in the next five to 10 years.

In partnership with the Rwandan and Belgian governments, Souopgui said they are implementing a five-year minimally invasive surgery project in Rwanda, which seeks to train surgeons in the country to be able to perform the procedure.

"We are creating a fellowship at the University of Rwanda's Faculty of Medicine to create a pool of Rwandans who will be able to carry out minimally invasive surgery," he said.

He believes that the sustainability of the programme lies in incorporating it into the curriculum of the medical students, and that this would help breed a critical mass of professionals.

Centre for minimally invasive surgery

Rwanda is currently making huge investments in adopting modern technologies to improve the health sector.

Health minister Diane Gashumba said Rwanda has been considering the possibility of training specialists in minimally invasive surgery and that the plan was fueled by private players.

"We are making it a top priority to adopt minimally invasive surgery and we have had this idea, but it was boosted by private players like Prof. Souopgui and Jacques Marescaux, the president of France-Research Institute against Digestive Cancer (IRCAD)," she says.

IRCAD is recognised worldwide as a reference training centre in micro invasive surgery, operating in France, Taiwan, and Brazil.

In a recent interview, Dr Gashumba said that when Marescaux visited Rwanda and met President Kagame this year, the discussions resulted into an agreement to establish IRCAD Centre in Rwanda, and that the centre will focus mainly on training people in minimally invasive surgery.

"The biggest work we are doing today is to establish the right infrastructure, strengthen human resource capacity and equip facilities with equipment that will enable practitioners to carry out these procedures," she said, adding that Government is also considering integrating minimally invasive surgery in the curriculum.

Once established and all other projects regarding the adoption of minimally invasive surgery take off, the minister believes that more money will be saved, hospitalisation time reduced, and doctors will be enabled to do other productive activities.

Dr Gashumba said there are more initiatives that the Government is putting in place to build capacities for local medics.

editorial@newtimes.co.rw

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