A structured training module using an inexpensive endotrainer for improving the performance of trainee surgeons

Abstract

Training in minimal access surgery has always been difficult in developing countries with limited resources, non availability of formal animal labs, inaffordability of conventional endotrainers and lack of trained endosurgeons to help the amateurs. It is always difficult to start a new procedure in such places where not only the patients but the orthodox surgical fraternity are reluctant to accept new ideas and newer trends in surgery. After thorough discussions with senior surgeons, the author (who was the only trained endosurgeon to begin with) developed a training policy to train the surgeons over a period of time through various exercises before allowing them to assist him in the actual surgeries. A homemade, inexpensive endotrainer was designed for these exercises. Audio-visual seminars were held in between the training sessions. This training module can be employed by other rural hospitals to improve the skills of surgeons who are new to the art of endosurgery.

Laparoscopy in Rwanda: A National Assessment of Utilization, Demands, and Perceived Challenges

“…In Mongolia, more than 315 Mongolian practitioners received laparoscopic training over 9 years (2005-2013), and laparoscopic cholecystectomy surpassed open cholecystectomy as the primary method for gallbladder removal at a national scale [32]. Lectures, workshops, laboratory-based trainers, makeshift trainer boxes, and animal models can be used to build skills outside of the operating room [34][35][36][37][38]. Competency based training with and pre-and post-test evaluations and a designated number of procedures should be required for graduation [39,40].…”

Colorectal Surgery Practice, Training, and Research in Low-Resource Settings

“…53 Studies from Tanzania, India, and Botswana have demonstrated significantly better technical outcomes after laparoscopic simulation. [54][55][56] However, laparoscopic simulation has not been widely rolled out to teach laparoscopic CRS in LMICs. Low-fidelity, low-cost simulation can also be used to teach open CRS procedures.…”

Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review

“…Moreover, in many LMICs it is difficult to promote new ideas in surgery, not only among patients but also among local surgeons due to cultural and social barriers [ 5 ]. However, initiatives are being implemented in LMICs in order to train dedicated health workers and to promote laparoscopy, especially in order to minimize post-surgical infection and to reduce recovery time [ 6 , 7 ]. More importantly, the advantages of laparoscopy compared to open surgery could be even more evident in settings with limited access to blood transfusion, clean water, and poor healthy living conditions [ 8 ].…”