**2.3 Current status of minimally invasive surgery in the world**

Traditionally, open surgical approaches have been the mainstay of surgical treatment, but in recent years the number of open surgeries has largely decreased in developed countries in favor of minimally invasive surgery in all surgical specialties [12].

Minimally invasive surgery has become the standard in many specialties and has overtaken traditional surgery in many cases.

Indeed, this type of surgery offers patients multiple benefits such as smaller incisions, faster recovery times, reduced adhesion rates, pain, morbidity, and postoperative length of stay, [13, 14]. It is therefore perfectly suitable for LMICs since, by reducing the length of hospital stays and speeding up recovery time, it reduces the total cost of surgery which is a major barrier to healthcare access for a significant population in these countries.

A major obstacle to assessing the adoption of this surgery worldwide is the lack of official data and publications in developing countries [2]. However, the limited published data from these countries indicate that the rates of laparoscopic surgery for gynecological indications are minimal and vary widely from hospital to hospital.

Published data from large referral hospitals in LMICs reported laparoscopic surgery rates for gynecological indications of less than 10% [15].
