ARTICLE: Building a Sustainable Laparoscopic Training Program in Dar es Salaam, Tanzania
Expanding access to laparoscopic surgery is crucial for improving surgical care in low- and middle-income countries (LMICs). Laparoscopic surgery offers significant benefits, such as reduced recovery times, fewer complications, and shorter hospital stays. However, the lack of trained professionals and accessible training facilities has limited its adoption in LMICs. Recognizing this need, previous CHESA fellows Drs. Brand and Philipo, along with CHESA collaborators Wibonela Seif, Dr. Alseidi and Dr. Brian, CHESA leadership members Drs. Akoko, Mwanga, and Ozgediz, and other key partners collaborated to tackle this issue. Subsequently, a structured laparoscopic simulation curriculum was developed at the Muhimbili University of Health and Allied Sciences in Tanzania to train local surgeons effectively.
The laparoscopy simulation curriculum was inspired by existing programs at the University of California, San Francisco (UCSF) and Pontificia Universidad Católica de Chile (PUC). Interested residents, fellows, and practicing surgeons from Tanzanian public hospitals to participate. Over 18 months, 51 participants engaged in structured training for a total of 1,909 hours, and receiving 3,940 pieces of individualized online feedback to refine their skills progressively.
The program was designed with a two-step approach, beginning with a laparoscopic skills before moving on to advanced procedures. Hands-on practice was complemented by a theoretical coursework, ensuring that participants developed a comprehensive understanding of minimally invasive techniques. During the curriculum, a trained Tanzanian lab manager was appointed to oversee the sessions and provide guidance. The use of digital feedback mechanisms also enabled trainees to track their progress and receive targeted improvements.
Following the training, 45% of participants reported actively performing laparoscopic procedures at their institutions, all of whom found the program to be very helpful or essential to their practice, and great at improving their confidence, operative times, and clinical outcomes when operating laparoscopically. Additionally, 85% of participants reported finding the curriculum to be helpful and useful.Although some reported barriers to operating laparoscopically, mainly due to a lack of laparoscopic equipment, those respondents noted that the curriculum encouraged them to advocate for expanded resources at their hospitals.
These findings not only highlight the program’s success in enhancing surgical capacity but also highlight its potential as a sustainable training model that can foster a culture of continuous learning and peer mentorship, empowering participants to train future cohorts. The success of this initiative underscores the potential for adapting similar programs across other LMICs. By integrating simulation-based training into medical education systems, institutions can build long-term capacity for minimally invasive surgery, ultimately improving patient outcomes and reducing the burden on healthcare facilities.
This initiative highlights the potential of structured laparoscopic training in strengthening surgical capacity in resource-limited settings. By investing in simulation-based education, leveraging local expertise, and fostering mentorship, similar programs can be implemented globally to expand access to minimally invasive surgery. The success of this training program can serve as a model for future efforts to close the gap in surgical care and improve health equity worldwide.
To learn more, read the full article here: https://link.springer.com/article/10.1007/s44186-024-00308-8
