INNOVATIVE APPROACHES IN LIMITEDRESOURCE SETTINGS: USE OF A NEBULIZER AS A SUBSTITUTE INSUFFLATOR AND A SMARTPHONE FLASHLIGHT AS A LIGHT SOURCE IN LAPAROSCOPY

Background: Minimally invasive surgery relies on reliable pneumoperitoneum creation and high-quality illumination.Sudden equipment failure during laparoscopy can compromise patient safety and often necessitates conversion to open surgery, particularly in low-resource settings where backup systems are unavailable.To describe and critically Aims: evaluate two emergency intraoperative adaptations-a medical nebulizer used as a substitute insufflator and a smartphone flashlight used as an alternative endoscopic light source-employed during unexpected equipment failure.Methods: Two intraoperative scenarios complicated by equipment malfunction were managed using improvised techniques.Safety, feasibility, physiological parameters, intraoperative stability, and postoperative outcomes were assessed and contextualized against available literature.During laparoscopic cholecystectomy complicated by sudden insufflator failure, a standard medical nebulizer was adapted to deliver gas through a 10-mm trocar, while intraabdominal pressure (IAP) was continuously monitored via a sphygmomanometer connected through a 5-mm port.In a separate case, failure of the endoscopic light source during cystoscopic double-J stent removal was managed by coupling a smartphone flashlight with the fiberoptic cable.Stable pneumoperitoneum (12-15 mmHg) was Results: achieved using the nebulizer without hemodynamic or respiratory compromise, allowing completion of laparoscopic cholecystectomy without conversion.Smartphone flashlight illumination provided sufficient brightness for safe cystoscopic visualization.No intraoperative or postoperative complications were observed in either case.Conclusion: Emergency improvisations using commonly available devices can safely salvage minimally invasive procedures in resource-constrained environments when applied judiciously, by experienced teams, and with vigilant monitoring.These techniques must remain restricted to emergency use and should not replace standard laparoscopic equipment.