Capacity building program in minimally invasive surgery for developing countries
Laparoscopic (minimal access) surgery has now existed for more than 100 years (Perissat, 1999). Over this period, it has evolved to become a veritable tool for gynaecologists and an established surgical option for women seeking management for a wide range of gynaecological disorders. With appropriate training, laparoscopic surgery assures maximum efficiency with minimal adverse effects.
The training for laparoscopic surgery is complex, highly technical and requires significant resource investments. There has also been a growing interest among the surgical communities and academic institutions in resource-restricted countries to develop laparoscopic programs for fellows and trainees (Choy, 2013). This paradigm shift has led to the emergence of various models of collaboration in capacity building programs between institutions in developing countries and laparoscopic surgical units in developed countries.
Galukande et al (2011) proposed the concept of onsite training and mentorship by experienced expatriate practitioners as a viable model suitable for developing countries. Evidence supports this model as a sustainable option for resource-restricted countries. This collaborative initiative, therefore, incorporates these concepts and addresses the limitations of existing models of the laparoscopic training program. It also highlights the importance of developing the basic laparoscopic skills in a simulated environment prior to its transfer to live surgical procedures.
These simulated environments could involve live animal models (Wet laboratory) and/or a variety of laparoscopic simulators (Dry laboratory). Currently, a vast variety of simulators and models for laparoscopic training in gynaecology are now available. They vary widely in their platforms (physical or virtual reality), performance measures (outcome based or movement based), cost intensity and their demonstrated validation level. This program will use the Simsei physical simulator box trainer provided by Applied Medical Australia
Specifically, course activities will focus on eye-hand coordination, two-handed manoeuvres, surgeon/assistant coordinated manoeuvres and proficiencies in laparoscopic suturing and knotting techniques. The course will use the Simsei simulator box trainer with laparoscopic instruments similar to those used in live laparoscopy.