{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T19:22:07Z","timestamp":1794424927886,"version":"4.9.1"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although laparoscopic surgery delivers substantial clinical benefits, its adoption across low- and middle-income countries (LMICs) remains inconsistent and incomplete. This systematic review aims to synthesise the barriers and facilitators of laparoscopic surgery adoption within LMICs healthcare systems using the Consolidated Framework for Implementation Research (CFIR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive systematic search was conducted in PubMed, MEDLINE, ScienceDirect, Embase, and Scopus to identify studies reporting barriers and facilitators to the adoption of laparoscopic surgery in LMICs, as defined by the World Bank classification. Data were extracted using standardised forms, and all implementation factors were mapped to CFIR domains. Additionally, a systematic thematic analysis was then conducted to refine and interpret the extracted data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 18 studies, 417 factors were identified, including 222 barriers and 195 facilitators. Predominant barriers were high equipment costs (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a024, 11%), structural limitations (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018, 8%), and limited training capacity (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a027, 12%). Key facilitators included perceived clinical advantage (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a026, 13%), institutional leadership engagement (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a018, 9%), international collaboration (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a013, 7%), and technical adaptability (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011, 6%). Inner-setting factors were most frequently represented (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0114, 27%), reflecting institutional readiness as a critical determinant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of minimally invasive surgery in LMICs is shaped by barriers including infrastructure and training limitations and facilitators such as leadership, collaboration, and adaptability\u2014with inner-setting factors most frequent, indicating that strengthening institutional readiness is pivotal. Strategic deployment of international partnerships and locally tailored implementation pathways can accelerate equitable access to this essential surgical innovation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13414-z","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:47:28Z","timestamp":1791928048000},"page":"9418-9430","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Barriers and facilitators to implementing laparoscopic surgery in low- and middle-income countries: a systematic review using the consolidated framework for implementation research"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1219-7571","authenticated-orcid":false,"given":"Ali Yasen","family":"Mohamedahmed","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"},{"role":"corresponding-author","vocabulary":"crossref"}]},{"given":"Mohammed A.","family":"Adam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seddig Adam Jebril","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malaz A. E.","family":"Dafallah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar Elfaroug","family":"Salim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayla","family":"Bagg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johnelize","family":"Louw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiffany E.","family":"Chao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Chu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"Suppl 2","key":"13414_CR1","doi-asserted-by":"publisher","first-page":"S13","DOI":"10.1016\/S2214-109X(15)70087-2","volume":"3","author":"J Rose","year":"2015","unstructured":"Rose J, Weiser TG, Hider P, Wilson L, Gruen RL, Bickler SW (2015) Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob Health 3(Suppl 2):S13\u2013S20. https:\/\/doi.org\/10.1016\/S2214-109X(15)70087-2","journal-title":"Lancet Glob Health"},{"issue":"3","key":"13414_CR2","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.thorsurg.2022.04.003","volume":"32","author":"Y Lin","year":"2022","unstructured":"Lin Y, Vervoort D, Thapa B, Sapkota R, Mitchell JD (2022) Minimally invasive thoracic surgery for low-and middle-income countries. Thorac Surg Clin 32(3):405\u2013412","journal-title":"Thorac Surg Clin"},{"issue":"3","key":"13414_CR3","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1177\/0049475521998186","volume":"51","author":"E Wilkinson","year":"2021","unstructured":"Wilkinson E, Aruparayil N, Gnanaraj J, Brown J, Jayne D (2021) Barriers to training in laparoscopic surgery in low-and middle-income countries: a systematic review. Trop Doct 51(3):408\u2013414","journal-title":"Trop Doct"},{"issue":"17","key":"13414_CR4","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015347","volume":"98","author":"X-J Song","year":"2019","unstructured":"Song X-J, Liu Z-L, Zeng R, Ye W, Liu C-W (2019) A meta-analysis of laparoscopic surgery versus conventional open surgery in the treatment of colorectal cancer. Medicine (Baltimore) 98(17):e15347","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"13414_CR5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.5334\/aogh.3377","volume":"87","author":"LI Losonczy","year":"2021","unstructured":"Losonczy LI, Papali A, Kivlehan S, Hynes EJC, Calderon G, Laytin A et al (2021) White paper on early critical care services in low resource settings. Ann Glob Health 87(1):105","journal-title":"Ann Glob Health"},{"issue":"1","key":"13414_CR6","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v9.i1.13","volume":"9","author":"M Alfa-Wali","year":"2017","unstructured":"Alfa-Wali M, Osaghae S (2017) Practice, training and safety of laparoscopic surgery in low and middle-income countries. World J Gastrointest Surg 9(1):13","journal-title":"World J Gastrointest Surg"},{"issue":"4","key":"13414_CR7","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s00268-008-9525-9","volume":"32","author":"PE Farmer","year":"2008","unstructured":"Farmer PE, Kim JY (2008) Surgery and global health: a view from beyond the OR. World J Surg 32(4):533\u2013536","journal-title":"World J Surg"},{"key":"13414_CR8","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/1748-5908-4-50","volume":"4","author":"LJ Damschroder","year":"2009","unstructured":"Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 4:50","journal-title":"Implement Sci"},{"issue":"1","key":"13414_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-022-01702-8","volume":"21","author":"HM Thompson","year":"2022","unstructured":"Thompson HM, Clement AM, Ortiz R, Preston TM, Quantrell ALW, Enfield M et al (2022) Community engagement to improve access to healthcare: a comparative case study to advance implementation science for transgender health equity. Int J Equity Health 21(1):104","journal-title":"Int J Equity Health"},{"key":"13414_CR10","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"JP Higgins","year":"2008","unstructured":"Higgins JP, Green S (2008) Cochrane handbook for systematic reviews of interventions"},{"issue":"5","key":"13414_CR11","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.ijsu.2010.02.007","volume":"8","author":"D Moher","year":"2010","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336\u2013341","journal-title":"Int J Surg"},{"issue":"4","key":"13414_CR12","doi-asserted-by":"publisher","first-page":"285","DOI":"10.3233\/EFI-180221","volume":"34","author":"QN Hong","year":"2018","unstructured":"Hong QN, F\u00e0bregues S, Bartlett G, Boardman F, Cargo M, Dagenais P et al (2018) The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf 34(4):285\u2013291. https:\/\/doi.org\/10.3233\/EFI-180221","journal-title":"Educ Inf"},{"key":"13414_CR13","doi-asserted-by":"publisher","DOI":"10.1177\/16094069231205789","volume":"22","author":"M Naeem","year":"2023","unstructured":"Naeem M, Ozuem W, Howell K, Ranfagni S (2023) A step-by-step process of thematic analysis to develop a conceptual model in qualitative research. Int J Qual Methods 22:16094069231205789","journal-title":"Int J Qual Methods"},{"issue":"7","key":"13414_CR14","doi-asserted-by":"publisher","first-page":"5121","DOI":"10.1007\/s00464-023-09985-w","volume":"37","author":"M Nyundo","year":"2023","unstructured":"Nyundo M, Umugwaneza N, Bekele A, Chikoya L, Gashegu J, Detry O (2023) Assessment of resource capacity and barriers to effective practice of laparoscopic surgery in training hospitals affiliated with the College of Surgeons of East, Central and Southern Africa (COSECSA). Surg Endosc 37(7):5121\u20135128","journal-title":"Surg Endosc"},{"issue":"11","key":"13414_CR15","doi-asserted-by":"publisher","first-page":"4009","DOI":"10.1007\/s00464-013-3019-z","volume":"27","author":"I Choy","year":"2013","unstructured":"Choy I, Kitto S, Adu-Aryee N, Okrainec A (2013) Barriers to the uptake of laparoscopic surgery in a lower-middle-income country. Surg Endosc 27(11):4009\u20134015","journal-title":"Surg Endosc"},{"issue":"12","key":"13414_CR16","doi-asserted-by":"publisher","first-page":"4128","DOI":"10.1007\/s00464-019-06720-2","volume":"33","author":"JB Imran","year":"2019","unstructured":"Imran JB, Ochoa-Hernandez A, Herrejon J, Ortiz C, Mijangos B, Madni T et al (2019) Barriers to adoption of laparoscopic cholecystectomy in a county hospital in Guatemala. Surg Endosc 33(12):4128\u20134132","journal-title":"Surg Endosc"},{"key":"13414_CR17","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.40761","author":"O Tanoli","year":"2023","unstructured":"Tanoli O, Ahmad H, Khan H, Khan A, Aftab Z, Khan MI et al (2023) Laparoscopy in low-and middle-income countries: a survey study. Cureus. https:\/\/doi.org\/10.7759\/cureus.40761","journal-title":"Cureus"},{"key":"13414_CR18","volume":"50","author":"SHB Damous","year":"2023","unstructured":"Damous SHB, Menegozzo CAM, Rocha MC, Utiyama E (2023) Challenges to implement laparoscopic appendectomy as the first-line treatment for acute appendicitis: a fifteen-year experience in a tertiary hospital in Brazil. Rev Col Bras Cir 50:e20233527","journal-title":"Rev Col Bras Cir"},{"issue":"1","key":"13414_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-024-05897-y","volume":"24","author":"MC Rombaldi","year":"2024","unstructured":"Rombaldi MC, Barreto CG, Rombaldi RL, Costa EC, Holanda F, Cavazzola LT et al (2024) Barriers to diffusion and implementation of pediatric minimally invasive surgery in Brazil. BMC Med Educ 24(1):906","journal-title":"BMC Med Educ"},{"issue":"2","key":"13414_CR20","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s12262-023-03889-8","volume":"86","author":"AK Gupta","year":"2024","unstructured":"Gupta AK, Srivastava N, Saurabh A, Srivastava Y (2024) Limiting factors for day care laparoscopic cholecystectomy in a rural setup. Indian J Surg 86(2):380\u2013384","journal-title":"Indian J Surg"},{"issue":"3","key":"13414_CR21","first-page":"37","volume":"1","author":"M Misauno","year":"2011","unstructured":"Misauno M (2011) Pilot experience with laparoscopic cholecystectomy in Jos, Nigeria-challenges and prospects. J West Afr Coll Surg 1(3):37","journal-title":"J West Afr Coll Surg"},{"issue":"2","key":"13414_CR22","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s00268-018-4797-1","volume":"43","author":"F Robertson","year":"2019","unstructured":"Robertson F, Mutabazi Z, Kyamanywa P, Ntakiyiruta G, Musafiri S, Walker T et al (2019) Laparoscopy in Rwanda: a national assessment of utilization, demands, and perceived challenges. World J Surg 43(2):339\u2013345","journal-title":"World J Surg"},{"issue":"8","key":"13414_CR23","doi-asserted-by":"publisher","first-page":"4415","DOI":"10.1007\/s00464-024-10960-2","volume":"38","author":"Y Yankunze","year":"2024","unstructured":"Yankunze Y, Mwachiro MM, Lando JO, Bachheta N, Mangaoang D, Bekele A et al (2024) Laparoscopy experience in East, Central, and Southern Africa: insights from operative case volume analysis. Surg Endosc 38(8):4415\u20134421","journal-title":"Surg Endosc"},{"issue":"10","key":"13414_CR24","doi-asserted-by":"publisher","first-page":"2421","DOI":"10.1002\/wjs.12330","volume":"48","author":"CW Reynolds","year":"2024","unstructured":"Reynolds CW, Mabanza T, Cassell A, Rooney DM, Moore\u2010Wilson Y, Ketia A et al (2024) Assessment of laparoscopic surgery practice, knowledge, and training goals in Liberia: a mixed\u2010methods study among Liberian surgeons. World J Surg 48(10):2421\u20132432","journal-title":"World J Surg"},{"issue":"10","key":"13414_CR25","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1007\/s004649900223","volume":"10","author":"H Asbun","year":"1996","unstructured":"Asbun H, Berguer R, Altamirano R, Castellanos H (1996) Successfully establishing laparoscopic surgery programs in developing countries: clinical results and lessons learned. Surg Endosc 10(10):1000\u20131003","journal-title":"Surg Endosc"},{"key":"13414_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2023.100556","author":"M Bryce-Alberti","year":"2023","unstructured":"Bryce-Alberti M, Campos LN, Dey T, Del Valle DD, Hill SK, Zaigham M et al (2023) Availability of laparoscopic surgery in Mexico\u2019s public health system: a nationwide retrospective analysis. Lancet Reg Health Am. https:\/\/doi.org\/10.1016\/j.lana.2023.100556","journal-title":"Lancet Reg Health Am"},{"issue":"1","key":"13414_CR27","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12893-024-02387-2","volume":"24","author":"SM Djote","year":"2024","unstructured":"Djote SM, Muhie DA, Alemayehu GD (2024) Advancing laparoscopy in resource-limited settings. BMC Surg 24(1):98","journal-title":"BMC Surg"},{"issue":"4","key":"13414_CR28","doi-asserted-by":"publisher","first-page":"353","DOI":"10.47717\/turkjsurg.2022.5713","volume":"38","author":"AC Esmer","year":"2022","unstructured":"Esmer AC, \u00c7olak T, Edizsoy A, Tazeo\u011flu D, Karaca AS (2022) Current status of laparoscopic surgery usage in T\u00fcrkiye: a middle-income country. Turk J Surg 38(4):353","journal-title":"Turk J Surg"},{"issue":"2","key":"13414_CR29","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/j.surg.2016.04.001","volume":"160","author":"KM Wells","year":"2016","unstructured":"Wells KM, Lee Y-J, Erdene S, Erdene S, Sanchin U, Sergelen O et al (2016) Building operative care capacity in a resource limited setting: the Mongolian model of the expansion of sustainable laparoscopic cholecystectomy. Surgery 160(2):509\u2013517","journal-title":"Surgery"},{"issue":"8","key":"13414_CR30","doi-asserted-by":"publisher","first-page":"6548","DOI":"10.1007\/s00464-023-10192-w","volume":"37","author":"A Ndong","year":"2023","unstructured":"Ndong A, Diallo AC, Rouhi AD, Diao ML, Yi W, Tendeng JN et al (2023) Evolution of laparoscopic surgery in a sub-Saharan African country: a 30-year literature review in Senegal. Surg Endosc 37(8):6548\u20136557","journal-title":"Surg Endosc"},{"issue":"3","key":"13414_CR31","doi-asserted-by":"publisher","first-page":"197","DOI":"10.4103\/1117-1936.170509","volume":"18","author":"O Afuwape","year":"2011","unstructured":"Afuwape O, Akute O (2011) The challenges and solutions of laparoscopic surgical practice in the developing countries. Niger Postgrad Med J 18(3):197\u2013199","journal-title":"Niger Postgrad Med J"},{"issue":"4","key":"13414_CR32","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/j.0887-378X.2004.00325.x","volume":"82","author":"T Greenhalgh","year":"2004","unstructured":"Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O (2004) Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 82(4):581\u2013629","journal-title":"Milbank Q"},{"issue":"1","key":"13414_CR33","doi-asserted-by":"publisher","first-page":"63","DOI":"10.4018\/irmj.2009010104","volume":"22","author":"B Jukic","year":"2009","unstructured":"Jukic B, Jukic N, Velasco M (2009) Enterprise information systems change, adaptation and adoption: a qualitative study and conceptualization framework. Inf Resour Manag J (IRMJ) 22(1):63\u201387","journal-title":"Inf Resour Manag J (IRMJ)"},{"key":"13414_CR34","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.ijoa.2015.09.006","volume":"25","author":"JG Meara","year":"2030","unstructured":"Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA et al (2030) Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth 25:75\u201378","journal-title":"Int J Obstet Anesth"},{"issue":"5","key":"13414_CR35","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2019-001785","volume":"4","author":"IH Marks","year":"2019","unstructured":"Marks IH, Thomas H, Bakhet M, Fitzgerald E (2019) Medical equipment donation in low-resource settings: a review of the literature and guidelines for surgery and anaesthesia in low-income and middle-income countries. BMJ Glob Health 4(5):e001785","journal-title":"BMJ Glob Health"},{"issue":"8","key":"13414_CR36","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1016\/j.ijsu.2014.07.009","volume":"12","author":"R Ologunde","year":"2014","unstructured":"Ologunde R, Maruthappu M, Shanmugarajah K, Shalhoub J (2014) Surgical care in low and middle-income countries: burden and barriers. Int J Surg 12(8):858\u2013863","journal-title":"Int J Surg"},{"key":"13414_CR37","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002375","author":"CL Reddy","year":"2020","unstructured":"Reddy CL, Peters AW, Jumbam DT, Caddell L, Alkire BC, Meara JG et al (2020) Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries. BMJ Glob Health. https:\/\/doi.org\/10.1136\/bmjgh-2020-002375","journal-title":"BMJ Glob Health"},{"issue":"10","key":"13414_CR38","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070406","volume":"8","author":"J Hanefeld","year":"2013","unstructured":"Hanefeld J, Horsfall D, Lunt N, Smith R (2013) Medical tourism: a cost or benefit to the NHS? PLoS ONE 8(10):e70406","journal-title":"PLoS ONE"},{"issue":"10","key":"13414_CR39","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.5306\/wjco.v15.i10.1256","volume":"15","author":"CM Ardila","year":"2024","unstructured":"Ardila CM, Gonz\u00e1lez-Arroyave D (2024) Precision at scale: machine learning revolutionizing laparoscopic surgery. World J Clin Oncol 15(10):1256\u20131263","journal-title":"World J Clin Oncol"},{"issue":"2","key":"13414_CR40","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1007\/s00464-009-0569-1","volume":"24","author":"JE Varela","year":"2010","unstructured":"Varela JE, Wilson SE, Nguyen NT (2010) Laparoscopic surgery significantly reduces surgical-site infections compared with open surgery. Surg Endosc 24(2):270\u2013276","journal-title":"Surg Endosc"},{"issue":"3","key":"13414_CR41","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.thorsurg.2022.02.003","volume":"32","author":"R Koch","year":"2022","unstructured":"Koch R, Felsted AM, Virk S, Roy N, Jayaraman S (2022) Surgical capacity building in low- and middle-income countries: lessons for thoracic surgery. Thorac Surg Clin 32(3):269\u2013278","journal-title":"Thorac Surg Clin"},{"issue":"4","key":"13414_CR42","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.jsurg.2016.02.007","volume":"73","author":"MV Schaverien","year":"2016","unstructured":"Schaverien MV (2016) Selection for surgical training: an evidence-based review. J Surg Educ 73(4):721\u2013729","journal-title":"J Surg Educ"},{"issue":"10 Suppl","key":"13414_CR43","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.1097\/00001888-200410001-00022","volume":"79","author":"KA Ericsson","year":"2004","unstructured":"Ericsson KA (2004) Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med 79(10 Suppl):S70-81","journal-title":"Acad Med"},{"issue":"1","key":"13414_CR44","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-025-01463-2","volume":"20","author":"R L\u00fcchinger","year":"2025","unstructured":"L\u00fcchinger R, Aud\u00e9tat M-C, Blondon K, Junod Perron N (2025) Implementing collaborative practices in healthcare settings using champions: a scoping review. Implement Sci 20(1):48","journal-title":"Implement Sci"},{"issue":"1","key":"13414_CR45","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s13012-020-0977-0","volume":"15","author":"AR Means","year":"2020","unstructured":"Means AR, Kemp CG, Gwayi-Chore MC, Gimbel S, Soi C, Sherr K et al (2020) Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: a systematic review. Implement Sci 15(1):17","journal-title":"Implement Sci"},{"issue":"2","key":"13414_CR46","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1097\/00000658-200002000-00019","volume":"231","author":"N Demartines","year":"2000","unstructured":"Demartines N, Mutter D, Vix M, Leroy J, Glatz D, R\u00f6sel F et al (2000) Assessment of telemedicine in surgical education and patient care. Ann Surg 231(2):282\u2013291","journal-title":"Ann Surg"},{"issue":"12","key":"13414_CR47","doi-asserted-by":"publisher","first-page":"1452","DOI":"10.1111\/acem.14330","volume":"28","author":"EM Hayden","year":"2021","unstructured":"Hayden EM, Davis C, Clark S, Joshi AU, Krupinski EA, Naik N et al (2021) Telehealth in emergency medicine: a consensus conference to map the intersection of telehealth and emergency medicine. Acad Emerg Med 28(12):1452\u20131474","journal-title":"Acad Emerg Med"},{"issue":"11","key":"13414_CR48","doi-asserted-by":"publisher","first-page":"2628","DOI":"10.1007\/s00268-016-3579-x","volume":"40","author":"Y Zha","year":"2016","unstructured":"Zha Y, Stewart B, Lee E, Remick KN, Rothstein DH, Groen RS et al (2016) Global estimation of surgical procedures needed for forcibly displaced persons. World J Surg 40(11):2628\u20132634","journal-title":"World J Surg"},{"key":"13414_CR49","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00059","volume":"8","author":"DK King","year":"2020","unstructured":"King DK, Shoup JA, Raebel MA, Anderson CB, Wagner NM, Ritzwoller DP et al (2020) Planning for implementation success using RE-AIM and CFIR frameworks: a qualitative study. Front Public Health 8:59","journal-title":"Front Public Health"},{"issue":"11","key":"13414_CR50","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1016\/j.trstmh.2008.04.023","volume":"102","author":"SN Kiwanuka","year":"2008","unstructured":"Kiwanuka SN, Ekirapa EK, Peterson S, Okui O, Rahman MH, Peters D et al (2008) Access to and utilisation of health services for the poor in Uganda: a systematic review of available evidence. Trans R Soc Trop Med Hyg 102(11):1067\u20131074","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"1","key":"13414_CR51","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s43058-023-00454-y","volume":"4","author":"B Meshkovska","year":"2023","unstructured":"Meshkovska B, Gebremariam MK, Atukunda P, Iversen PO, Wandel M, Lien N (2023) Barriers and facilitators to implementation of nutrition-related actions in school settings in low- and middle-income countries (LMICs): a qualitative systematic review using the Consolidated Framework for Implementation Research (CFIR). Implement Sci Commun 4(1):73","journal-title":"Implement Sci Commun"},{"issue":"1","key":"13414_CR52","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-020-01003-0","volume":"15","author":"A Bergstr\u00f6m","year":"2020","unstructured":"Bergstr\u00f6m A, Ehrenberg A, Eldh AC, Graham ID, Gustafsson K, Harvey G et al (2020) The use of the PARIHS framework in implementation research and practice\u2014a citation analysis of the literature. Implement Sci 15(1):68","journal-title":"Implement Sci"},{"issue":"2","key":"13414_CR53","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1002\/jrsm.1378","volume":"11","author":"M Gusenbauer","year":"2020","unstructured":"Gusenbauer M, Haddaway NR (2020) Which academic search systems are suitable for systematic reviews or meta-analyses? Evaluating retrieval qualities of Google Scholar, PubMed, and 26 other resources. Res Synth Methods 11(2):181\u2013217","journal-title":"Res Synth Methods"},{"issue":"4","key":"13414_CR54","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","volume":"11","author":"V Braun","year":"2019","unstructured":"Braun V, Clarke V (2019) Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health 11(4):589\u2013597","journal-title":"Qual Res Sport Exerc Health"},{"issue":"2","key":"13414_CR55","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1097\/SLA.0b013e318176bf4b","volume":"248","author":"C Paradis","year":"2008","unstructured":"Paradis C (2008) Bias in surgical research. Ann Surg 248(2):180\u2013188","journal-title":"Ann Surg"},{"issue":"2","key":"13414_CR56","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1177\/8756479320976130","volume":"37","author":"B Yao","year":"2021","unstructured":"Yao B (2021) International research collaboration: challenges and opportunities. J Diagn Med Sonogr 37(2):107\u2013108","journal-title":"J Diagn Med Sonogr"},{"issue":"2","key":"13414_CR57","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s10488-010-0319-7","volume":"38","author":"E Proctor","year":"2011","unstructured":"Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A et al (2011) Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health 38(2):65\u201376","journal-title":"Adm Policy Ment Health"},{"issue":"Suppl 3","key":"13414_CR58","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/1475-6773.14175","volume":"58","author":"AA Baumann","year":"2023","unstructured":"Baumann AA, Shelton RC, Kumanyika S, Haire-Joshu D (2023) Advancing healthcare equity through dissemination and implementation science. Health Serv Res 58(Suppl 3):327\u201344","journal-title":"Health Serv Res"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13414-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13414-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13414-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T18:45:11Z","timestamp":1794422711000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13414-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":58,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["13414"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-13414-z","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"assertion":[{"value":"9 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ali Yasen Mohamedahmed, Mohammed A. Adam, Seddig Adam Jebril Saleh, Malaz A. E. Dafallah, Omar Elfaroug Salim, Kayla Bagg, Johnelize Louw, Tiffany E. Chao, and Kathryn Chu have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received exemption from ethical approval by the Health Research Ethics Committee, Stellenbosch University, South Africa. This work has been conducted in partial fulfilment of the requirements for the Global Surgery master\u2019s degree at Stellenbosch University, South Africa.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}