How Should Laparoscopic Surgery Training be Planned in a Resource-Limited Environment?

OBJECTIVE

Laparoscopic surgeries (LSs) are underperformed in low-income countries with inadequate health infrastructure due to many restrictive factors. In this study, we aimed to present the process and results of the first bilateral collaboration protocol (BCP) for LS in an African university hospital where laparoscopic surgery had not been performed before.

DESIGN

A 3-stage BCP was implemented between the University of Health Sciences (Turkey) and Jigjiga University Hospital (Somali State, Ethiopia) between January and June 2024. In the first stage, training was received in Turkey for 3-6 months. In the second stage, 2 general surgery, 2 gynecology and obstetrics, and one ear-nose-throat (ENT) clinic training officers from the University of Health Sciences went to Jigjiga University Hospital and provided the installation of laparoscopic devices, on-site training of surgeons and other operating room personnel, and the initiation of the first laparoscopic and minimally invasive surgeries for a week. In the third stage, LS performed in the first 30 days after the end of the program were connected via video call.

SETTING

This training was held at Jigjiga University Hospital, the only university hospital in the Somali state of Ethiopia.

PARTICIPANTS

The first stage of this training was attended by the teaching staff of the surgical clinics at Jigjiga University Hospital. The second stage of the program was attended by all surgeons, clinical assistants, operating room nurses and staff at Jigjiga University Hospital.

RESULTS

In the second stage of the program, a total of 25 patients underwent the first laparoscopic and minimally invasive surgeries in the state in 1 week. 13 (52%) were performed by general surgery, 7 (28%) by gynecology and 5 (20%) by ENT. In the third stage, 24 laparoscopic procedures were performed in the first 30 days.

CONCLUSIONS

In low-income countries with limited resources, laparoscopic surgeries can be introduced with the right training programs and appropriate bilateral collaboration programs.