Unmasking the challenges: a qualitative study of barriers to training pediatric surgeons for minimally invasive surgery in Pakistan.

PURPOSE: The primary objective of this study was to explore the obstacles faced by both trainees and trainers in acquiring and teaching MIS skills. Through the identification of gaps between global advancements and local practice, this study aims to provide insights into enhancing pediatric surgical care in Pakistan.

METHODS

This is a phenomenological qualitative study using semi-structured interviews conducted over a period of six months from March 2025 to August 2025, with approval from the institutional review board of King Edward Medical University. Braun and Clarke's six-step process of thematic analysis was followed.

RESULTS

The participants consisted of seven expert-level pediatric surgeons performing minimally invasive procedures, with a mean experience of 17.5 years, and five young consultants in the early stages of MIS training. The key themes identified were outdated equipment and infrastructure, a shortage of trained mentors, gaps in institutional policies, and an overall limited willingness to learn and address ethical concerns.

CONCLUSION

Pakistan, like other LMICs, lags in pediatric MIS. To keep up with the pace of integration and development of pediatric MIS, these barriers need to be addressed at the earliest by government support and funding for policy restructuring, equipment provision, scholarships, exchange programs, and quality control.