Introduction: Surgically treatable conditions are an increasing burden in low- and middle-income countries, and recent studies suggest they have overtaken the "big three" (malaria, tuberculosis and HIV) as a cause of mortality.
Aim: In this context, we have worked to modify standard laparoscopic equipment to allow laparoscopy in remote areas without support services such as bottled gases or disposable instruments.
Results: A simple and reliable system of gasless laparoscopy has been developed using robust reusable instruments, widening the potential availability of laparoscopic surgery in remote and rural areas.
Conclusion: Our findings suggest that, using this equipment, appropriately trained surgeons can provide minimally invasive surgery in even the most remote locations.
Keywords: CO2; General < technical; Instruments < technical; Surgical < technical.