Running a minimally invasive surgery course in a low or middleincome country.

Abstract

Aims: To describe our experience running an ''Essentials of Minimally Invasive Surgery (MIS)'' course in a low/middle-income country, to guide future courses. Method(s): Course in Kumasi, Ghana initiated by a local organiser running charitable healthcare services including paediatric surgery. 4 visiting surgeons from Europe using local equipment. Result(s): 18 candidates from various surgical specialities, consultant and trainee level, with minimal previous MIS experience, attended. The course ran over 4 days as morning lectures and afternoon practical sessions. There was sufficient equipment for 4 stations, using cardboard box simulators and rabbit/kid goat animal models. Candidates demonstrated clear progression in skills over the 4 days, notably equipment set up, port placement and dissection and suturing of tissues. Conclusion(s): The local organiser felt the course had been very successful and all candidates were very positive about the experience, except for the catering (which was excellent)! The visiting faculty all felt the teaching experience was very valuable but our reflections highlighted several areas for improvement. Clear understanding of the surgical and laparoscopic experience of candidates, ideally before the course, to tailor teaching appropriately. Understand candidates access to laparoscopic equipment and mentoring at their institution. The benefit of using simply made laparoscopic trainers for improving instrument handling and 3D working should not be underestimated. Course manual. Size of animal models available may be very different to Europe. Custom regulations can restrict taking equipment. Costs of local medical licensing and video link facilities can prohibit live patient operating.