Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb;37(2):1528-1536.
doi: 10.1007/s00464-022-09438-w. Epub 2022 Jul 19.

Use of virtual platform for delivery of simulation-based laparoscopic training curriculum in LMICs

Zerubabbel K Asfaw  1 , Rachel Todd  1 , Unwana Abasi  1 , Maria Marcela Bailez  2   3 , Jacqueline Narvaez  3 , Ana Carrasquilla  4 , Raul Hernandez Centeno  5 , Guillermo Yanowsky Reyes  6 , Linda P Zhang  7   8
Affiliations

Use of virtual platform for delivery of simulation-based laparoscopic training curriculum in LMICs

Zerubabbel K Asfaw et al. Surg Endosc. 2023 Feb.

Abstract

Background: Laparoscopic surgery is rapidly expanding in low-and middle-income countries (LMICs), yet many surgeons in LMICs have limited formal training in laparoscopy. In 2017, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) implemented Global Laparoscopic Advancement Program (GLAP), an in-person simulation-based laparoscopic training curriculum for surgeons in LMICs. In light of COVID-19, SAGES adapted GLAP to a virtual format with telesimulation. This study explores the feasibility and efficacy of virtual laparoscopic simulation training in resource-limited settings.

Methods: Participants from San Jose, Costa Rica, Leon, México, and Guadalajara, México enrolled in the virtual GLAP curriculum, meeting biweekly for 2-h didactic classes and 2-h hands-on live simulation practice. Surgical residents' laparoscopic skills were evaluated using the five Fundamentals of Laparoscopic Surgery (FLS) tasks during the initial and final weeks of the program. Participants also completed pre-and post-program surveys assessing their perception of simulation-based training.

Results: The study cohort consisted of 16 surgical attendings and 20 general surgery residents. A minimum 70% response rate was recorded across all surveys in the study. By the end of GLAP, residents completed all five tasks of the FLS exam within less time relative to their performance at the beginning of the training program (p < 0.05). Respondents (100%) reported that the program was a good use of their time and that education via telesimulation was easily reproduced. Participants indicated that the practice sessions, guidance, and feedback offered by mentors were their favorite elements of the training.

Conclusion: A virtual simulation-based curriculum can be an effective strategy for laparoscopic skills training. Participants demonstrated an improvement in laparoscopic skills, and they appreciated the mentorship and opportunity to practice laparoscopic skills. Future programs can expand on using a virtual platform as a low-cost, effective strategy for providing laparoscopic skills training to surgeons in LMICs.

Keywords: Global surgery; Laparoscopic surgery; Low-and middle-income countries; Simulation-based learning; Telementoring; Teleproctoring.

PubMed Disclaimer

References

    1. Bennett J, Boddy A, Rhodes M (2007) Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech 17:245–255. https://doi.org/10.1097/SLE.0b013e318058a117 - DOI - PubMed
    1. Coccolini F, Catena F, Pisano M, Gheza F, Fagiuoli S, Di Saverio S, Leandro G, Montori G, Ceresoli M, Corbella D, Sartelli M, Sugrue M, Ansaloni L (2015) Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis. Int J Surg 18:196–204. https://doi.org/10.1016/j.ijsu.2015.04.083 - DOI - PubMed
    1. Chao TE, Mandigo M, Opoku-Anane J, Maine R (2016) Systematic review of laparoscopic surgery in low- and middle-income countries: benefits, challenges, and strategies. Surg Endosc 30:1–10. https://doi.org/10.1007/s00464-015-4201-2 - DOI - PubMed
    1. Wilkinson E, Aruparayil N, Gnanaraj J, Brown J, Jayne D (2021) Barriers to training in laparoscopic surgery in low- and middle-income countries: a systematic review. Trop Doct 51:408–414. https://doi.org/10.1177/0049475521998186 - DOI - PubMed - PMC
    1. Robertson F, Mutabazi Z, Kyamanywa P, Ntakiyiruta G, Musafiri S, Walker T, Kayibanda E, Mukabatsinda C, Scott J, Costas-Chavarri A (2019) Laparoscopy in Rwanda: a national assessment of utilization, demands, and perceived challenges. World J Surg 43:339–345. https://doi.org/10.1007/s00268-018-4797-1 - DOI - PubMed

LinkOut - more resources