Sustainable Implementation of Laparoscopy in Low-income Countries (2021-2022)

Laparoscopic surgery is the standard of care for many surgical diseases in high-income countries, but it is not available in most low- and middle-income countries (LMICs) because of prohibitive costs.

Since 2018, this project team has been working to increase access to laparoscopic surgery by developing a low-cost and reusable laparoscope suitable for use in LMICs. Building on the work of previous teams, the 2021-2022 team introduced an improved KeySuite meant for operating rooms in sub-Saharan Africa. The KeySuite is a comprehensive set of prototypes, including the KeyScope (a maintenance-free laparoscope); KeyMentoring (software that allows surgeons in different locations to interact audibly and visually during surgery, enabling information exchange and remote mentoring); and KeyLoop Retractor (laparoscopic retractor that eliminates need for carbon dioxide, pressure regulation and continuous electricity). 

Working with surgical and biomedical engineering colleagues in Uganda, team members collaborated with international stakeholders, surgeons and engineers to make improvements to the KeyScope; developed manufacturing process instructions (MPI): to enable the laparoscopic technology to be constructed locally in sub-Saharan Africa; and analyzed baseline laparoscopic data: from surgeons in the U.S., Uganda, Singapore, Papua New Guinea and Myanmar about the types of laparoscopic cases they are performing and the problems that they have with current laparoscopes.

Learn more about this project team by viewing the team's video.


Summer 2021 – Summer 2022


John Boom

Team Outputs

KeyLoop Retractor for Global Gasless Laparoscopy: Evaluation of Safety and Feasibility in a Porcine Model. Siddhesh Zadey, Harold Leraas, Aryaman Gupta, Arushi Biswas, Pierce Hollier, Joao Ricardo Nickenig Vissoci, Julius Mugaga, Robert T. Ssekitoleko, Jeffrey I. Everitt, Amos H. P. Loh, York Tien Lee, Ann Saterbak, Jenna L. Mueller, Tamara N. Fitzgerald. 2023. Surgical Endoscopy.

Gupta A., Brown E., Davis J.T., Sekabira J., Mueller J., Fitzgerald T.N..  KeyLoop: Mechanical Retraction of the Abdominal Wall for Gasless Laparoscopy. 2022. J Surg Innovation 29(1):88-97.

Farrow N.E., Commander S.J., Reed C.R., Mueller J., Gupta A., Loh A.H.P., Sekabira J., 
Fitzgerald T.N. Laparoscopic Experience and Attitudes Towards a Low-Cost Laparoscopic System Among Surgeons in East, Central and Southern Africa. 2021. Surg Endoscopy 35(12):6539-6548.

Mueller J.L., Rozman N., Sunassee E.D., Gupta A., Schuval C., Biswas A., Knight B., Kulkarni S., Brown M., Ramanujam N., Fitzgerald T.N. An Accessible Laparoscope for Surgery in Low- and Middle-Income Countries. 2021. Annals of BME 49(7):1657-1669.

Improving Access to Laparoscopic Surgery in Low- and Middle-Income Countries. Siddhesh Zadey, Jenna Mueller, Tamara N. Fitzgerald. 2022. JAMA Surgery.

Tamara Fitzgerald. NIH U01: Cancer Technologies for LMICs ($2,000,000 grant awarded from National Institutes of Health, 2022)

Tamara Fitzgerald. NIH 1U01-CA269190-01: KeySuite: The Key to Sustainable Cancer Diagnosis and Treatment in Uganda ($2,621,330 grant awarded from National Institutes of Health, 2022)

This Team in the News

Senior Spotlight: Reflections from the Class of 2022

Two Faculty Recognized for Exceptional Co-Leadership of Bass Connections Team

Cut Costs, Not Patients: The Promise of Laparoscopic Surgery in Global Health

Educational Innovation: Beyond Methods Into Experiences – Part 2: The GWHT Network

See earlier related team, Increasing Access to Laparoscopic Surgery in Low-income Countries (2020-2021).


Image: Team members with Dr. Ibingira and Dr. Ssekitoleko at Makerere, courtesy of 2018-2019 project team

Team members with Dr. Ibingira and Dr. Ssekitoleko at Makerere, courtesy of 2018-2019 project team.

Team Leaders

  • Tamara Fitzgerald, School of Medicine-Surgery: Pediatric General Surgery
  • Jenna Mueller, University of Maryland
  • Ann Saterbak, Pratt School of Engineering-Biomedical Engineering

/graduate Team Members

  • Natalie Rozman, Electrical/Computer Engg-PHD, Electrical/Computer Engg-MS

/undergraduate Team Members

  • Vignesh Alagappan, Economics (BS)
  • Arushi Biswas, Biomedical Engineering (BSE)
  • John Boom, Biomedical Engineering (BSE)
  • Reed Chen, Biomedical Engineering (BSE)
  • Yi Chen, Electrical & Computer Egr(BSE)
  • Aarzu Gupta, Electrical & Computer Egr(BSE)
  • Rebecca Hogewood, Biomedical Engineering (BSE)
  • Pierce Hollier, Neuroscience (BS)
  • Khue Huynh, Biomedical Engineering (BSE)
  • Aleksandra Koroza, Biomedical Engineering (BSE)
  • Tiffany Liu, Biology (BS)
  • Caroline Maloney, Biology (BS)
  • Jamila Otieno, Computer Science (BS)
  • Saajan Patel, Biology (BS)
  • Alan Tang, Neuroscience (BS)
  • Ria Thimmaiahgari, Biomedical Engineering (BSE)
  • Matthew Wang, Biomedical Engineering (BSE)
  • Sophia Williams, Electrical & Computer Egr(BSE)

/yfaculty/staff Team Members

  • Shannon Barter, School of Medicine-Surgery
  • Sarah Dunn Phillips, Margolis Center for Health Policy
  • Anthony Eze, School of Medicine-Surgery
  • Siddhesh Zadey, School of Medicine-Surgery

/zcommunity Team Members

  • Amos Loh, Duke-NUS, Singapore
  • Julius Mugaga, Makerere University
  • John Sekabira, Mulago Hospital, Uganda
  • Robert Ssekitoleko, Makerere University-Kampala
  • Anne Wesonga, Mulago Hospital, Uganda