History of Laparoscopic Surgery in the English-Speaking Caribbean and Progress Amidst a Mix of Challenges and Opportunities

Main Article Content

Shamir O Cawich


This discursive paper recounts the history of laparoscopic surgery in the English-Speaking Caribbean since the first recorded procedure in 1991. We discuss the challenges faced by early laparoscopic surgeons and analyze how they seized opportunities to overcome barriers against laparoscopy. This paper is important as it can serve as a template for development of laparoscopic surgery in other low-resource areas across the globe.

Article Details

How to Cite
CAWICH, Shamir O. History of Laparoscopic Surgery in the English-Speaking Caribbean and Progress Amidst a Mix of Challenges and Opportunities. Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4640>. Date accessed: 11 dec. 2023. doi: https://doi.org/10.18103/mra.v11i10.4640.
Case Reports


1. Naraynsingh V, Bahadursingh S, Maharaj R, Harnarayan P, Cawich SO. Surgery in the West Indies: A perspective from Trinidad. Curr Med Res Prac. 2014;4:1126-129.
2. Ward E, Fox K, Ricketts L, et al. A Review of hospital care in Jamaica: Morbidity and Mortality patterns, resource allocation and cost of care. West Ind Med J. 2001; 50 (S2): 21.
3. Plummer JM, Roberts PO, Leake PA, Mitchell DIG. Surgical care in Jamaica in the laparoendoscopic era: challenges and future prospects for developing nations. Perm J. 2011; 15(1): 57-61.
4. Cawich SO, Cherian CJ, Wilson C, Baker A, Lloyd C, Thomas C. Challenges against the advancement of minimally invasive surgery in Jamaica: A national hospital survey. West Ind Med J. 2012; 61(S4): 54
5. McGaw CD, Tennant I, Harding HE, Cawich SO, Crandon IW, Walters CA. Healthcare workers’ attitudes to and compliance with infection control guidelines in the operating department at the University Hospital of the West Indies, Jamaica. Int J Infect Control. 2012; 8(13):1-4 doi 10.3396/ijic.v8i3.023.12
6. Wilson CB, Cawich CO, Simpson LK, Baker AJA. Starting a Laparoscopic Surgery Service in a Rural Community Hospital in Jamaica: Successes and Challenges of the Percy Junor Hospital Experience. Caribb Med J. 2014;76:16–19
7. Hariharan S, Chen D. Costs and Utilization of Operating Rooms in a Public Hospital in Trinidad, West Indies. Perm J. 2015; 19(4): e128-32.
8. George EI, Brand TC, LaPorta A, Marescaux J, Satava RM. Origins of Robotic Surgery: From Skepticism to Standard of Care. JSLS. 2018;22(4):e2018.00039
9. Leake PA, Qureshi A, Plummer J, Orkainec A. Minimally invasive surgery training in the Caribbean - a survey of general surgical residents and their trainers. West Ind Med J. 2012:61(7):708-715.
10. Cawich SO, Pooran S, Amow B, Ali E, Mohammed F, Mencia M, Ramsewak S, Hariharan S, Naraynsingh V. Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean. Risk Manag Healthc Policy. 2016;9:253-260.
11. Parker M, Ramdass MJ, Cawich S, Fa Si Oen P, Rosin D. A historical perspective on the introduction of laparoscopic basic surgical training in the Caribbean and factors that contribute to the sustainability of such training. Int J Surg. 2019;72:6-12.
12. Cawich SO, Kabiye D. Developing Laparoscopic Surgery on the Caribbean Island of St. Lucia: A Model for Public-Private Partnership. Cureus. 2019; 11(10): e6011. DOI 10.7759/cureus.6011
13. Cawich S O, Burgess P E, Ranglin-Robinson D, et al. Single-Incision Laparoscopic Cholecystectomy: Initial Report From the Turks and Caicos Islands. Cureus. 2021; 13(5): e14891. DOI 10.7759/cureus.14891
14. Cawich SO, Mahadeo C, Rambaran M, Amir S, Rajkumar S, Crandon IW, Naraynsingh V. Advancement of laparoscopic surgery in Guyana: a working mode for developing countries. Adv Med Educ Pract. 2016;7:605-610
15. Cawich SO, Simpson LK, Wilson C, Baker A, Cherian C, SoTwe Y, Bonadie KO, Williams EW, Lloyd C, Thomas C. Healthcare workers’ Attitudes Toward Laparoscopic Surgery for Gallbladder Disease in the Caribbean. Current Med Res Pract. 2019;9(1):10-13.
16. PAHO. Health in the Americas: Health Financing in the Americas. [Available online at: https://www.paho.org/salud-en-las-americas-2017/uh-financing.html]. Accessed on September 17, 2023
17. Perry L, Malki R. Effectiveness of medical equipment donations to improve health systems: how much medical equipment is broken in the developing world? Med Biol Eng Comput. 2011; 49:719–722
18. Cawich SO, Johnson PB, Dan D, Naraynsingh V. Surgical Leadership in the Time of Significant Generational Diversity. Surgeon. 2014; 12(4): 235-6
19. Cawich SO, Harding HE, Crandon IW, McGaw CD, Barnett AT, Tennant I, Evans NR, Martin AC, Simpson LK, Johnson PB. Leadership in Surgery for Public Sector Hospitals in Jamaica: Strategies in the Operating Room. Perm J. 2013:17(3):121-125.
20. Reynolds W. The First Laparoscopic Cholecystectomy JSLS 2001:5(1):89-94.
21. Goleman D. What makes a Leader? Harvard Business Review. 2004; 82(1): 82-89.
22. Money SR, O’Donnel ME, Gray RJ. In the time of significant generational diversity - Surgical leadership must step up! The Surgeon. 2014; 12: 3-6
23. Cawich SO, Johnson PB, Shah S, Roberts P, Arthurs M, Murphy T, Bonadie KO, Crandon IW, Harding HE, Abu-Hilal, Pearce NW. The Multidisciplinary Team Approach to Hepatobiliary Diseases: A Working Model in the Caribbean Setting. J Multidisciplinary Healthcare. 2014; 7: 227-30
24. Negron R. Personal Networks and Migration Decision: The Case of Jamaican Brain Drain. J Identity and Migration Studies. 2012: 6(1): 43-63.
25. Dugger CW. Small Developing Lands Hit Hardest by Brain Drain. New York Times. 2005; A9: 9
26. The Joint Commission: Strategies for addressing the evolving nursing crisis. Jt Comm J Qual Saf. 2003; 29(1): 41-50.
27. Hauff HM. Where has all the staff gone? Strategies to recruit and retain quality staff. Prog Transplant. 2007; 17(2): 89-93.
28. Johnson N. Analysis and Assessment of the Brain Drain Phenomenon and its Effect on Caribbean Countries. Florida Atlantic Comparative Studies Journal. 2009; 11: 1-16.
29. Dexter F, Ledolter J, Wachtel RE. Tactical decision making for selective expansion of operating room resources incorporating financial criteria and uncertainty in subspecialties’ future workloads. Anesth Analg. 2005; 100(5): 1425-32.
30. Maslow AH. A Theory of Human Motivation. Psycholog Rev. 1943; 50: 370-396.
31. Macario, Alex. Are Your Hospital Operating Rooms “Efficient”? Anesthesiology 2006; 105:237-40.
32. Strum DP, Vargas LG, May JH, Bashein G. Surgical suite utilization and capacity planning: a minimal cost analysis model. J Med Syst 1997;21:309-22.
33. Herzberg F. One More Time: How Do You Motivate Employees? 1968. Harv Bus Rev. 2003; 81(1): 87-96.
34. Plummer JM, Mitchell DIG, Arthurs M, Leake PA, Deans-Minott J, Cawich SO, Martin AC. Laparoscopic colectomy for colonic neoplasms in a developing country. International J Surg 2011;9(5):382-385.
35. Bailey HH, Dan D. An economic evaluation of laparoscopic cholecystectomy for public hospitals in Trinidad and Tobago. West Ind Med J 2005;54(2):110-115.
36. Montana PJ, Charnow BH. Leadership theory and practice. In Barron’s Business Review Series 3rd edition. Barron’s Publishers 2000. Chapter 14; Pg 254-275.
37. Cawich SO, Griffith S, Wilson C, FaSiOen P, Burgess P, Thomas DA, Mencia M, Pearce NW. Distance Mentoring in Minimally Invasive Surgery in the Caribbean: A Model for Low Resource Environments. Curr Med Res Prac. 2021; 11(3): 125-9
38. Calderon C, Maraj A, Roopnarine C, Crichlow J. WISQ (Women in Surgery Questionnaire): A Glimpse at the Caribbean Perspective. Am J Res Med Sci. 2021; 6(1): 1-4.
39. Shiwani HM. Mentoring for Surgical Skills: A Tool To Share The Workload. J Can Chir. 2007;50(6):432-433.
40. Weiss A, Lee KC, Blair SL, Ramamoorthy S. Eliminating Mentors in Favour of Collaborators: Review and Challenge of Current Mentorship Literature. J Minim Invasive Surg Sci. 2015;4(2):1-5.
41. Entezami P, Franxblau LE, Chung KC. Mentorship in surgical training: a systematic review. HAND. 2012;7:30–36
42. Cook A, Khoury A, Bagli D, McLorie GA, El Ghoneimi A, Farhat WA. The development of laparoscopic surgical skills in pediatric urologists: longterm outcome of a mentorship-training model. Can J Urol. 2005;12:2824-8.
43. Alfa-Wali M. Surgical Leadership Through Coaching. J Surg Educ. 2013;70(5):680-682.
44. Singletary SE. Mentoring Surgeons for the 21st Century. Ann Surg Oncol. 2005;12(11):848-860.
45. Randall R, Shepherd J, Van Beek F, Rosales JR, Zermeno MR. The Eastern Caribbean Currency Union: Institution, Performance and Policy Issues. 2000. Chapter 2: The Financial System. Publisher: International Monetary Fund. ISBN: 9781557758941. Available online at https://doi.org/10.5089/9781557758941.084
46. Cawich SO, Arulampalam T, Senasi R, Naraynsingh V. Robot-Assisted Minimally Invasive Surgery: First Report from the Caribbean. Cureus. 2021;13(10):e18739.
47.Cawich SO, Griffith S, Wilson C, Narayansingh V. Distance mentoring in advanced minimally invasive surgery in the Caribbean: A model for low-resource environments. Curr Med Res Prac. 2021; 11(3): 125-128.
48. Cawich SO, Mencia M, Thomas D, Spence R, Milne D, Naraynsingh V, Barrow S. Trauma Surgery via Distance Mentoring: A Model Inspired by the 2020 Pandemic. Trop Doct. 2021. 52(1): 102-103.
49. Griffith S, Cawich SO, Mencia M, et al. Laparoscopic Liver Resection by Distance Mentoring from Trinidad to Barbados: A Report. Cureus. 2019; 11(9): e5796.
50. Cawich SO, Simpson L, Josephs A. Laparoscopic Hepatectomy via Remote Mentoring From Jamaica to Trinidad. Cureus. 2021; 13(12): 20177.
51. Cawich SO, Naryansingh G, Ramdass MJ, Mencia M, Thomas DA, Barrow S, Naraynsingh V. Responses to Disrupted Operative Care during the Coronavirus (COVID) Pandemic at a Caribbean Hospital World J Clin Cases. 2022; 10(3):74-80
52. Eyob B, Boeck MA, FaSiOen PR, Cawich SO, Kluger MD. Ensuring safe surgical care across resource settings via surgical outcomes data & quality improvement initiatives. International J Surg 2019; 72: 27-32.