Section of Translational Anaesthesia and Surgery, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK.
Leeds Vascular Institute, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Br J Surg. 2019 Jan;106(2):e34-e43. doi: 10.1002/bjs.11036.
Effective dissemination of technology in global surgery is vital to realize universal health coverage by 2030. Challenges include a lack of human resource, infrastructure and finance. Understanding these challenges, and exploring opportunities and solutions to overcome them, are essential to improve global surgical care.
This review focuses on technologies and medical devices aimed at improving surgical care and training in low- and middle-income countries. The key considerations in the development of new technologies are described, along with strategies for evaluation and wider dissemination. Notable examples of where the dissemination of a new surgical technology has achieved impact are included.
Employing the principles of frugal and responsible innovation, and aligning evaluation and development to high scientific standards help overcome some of the challenges in disseminating technology in global surgery. Exemplars of effective dissemination include low-cost laparoscopes, gasless laparoscopic techniques and innovative training programmes for laparoscopic surgery; low-cost and versatile external fixation devices for fractures; the LifeBox pulse oximeter project; and the use of immersive technologies in simulation, training and surgical care delivery.
Core strategies to facilitate technology dissemination in global surgery include leveraging international funding, interdisciplinary collaboration involving all key stakeholders, and frugal scientific design, development and evaluation.
到 2030 年实现全民健康覆盖，有效的全球外科学技术传播至关重要。挑战包括缺乏人力资源、基础设施和资金。了解这些挑战，并探索克服这些挑战的机会和解决方案，对于改善全球外科护理至关重要。
本综述重点介绍旨在改善中低收入国家外科护理和培训的技术和医疗器械。描述了新技术开发的关键考虑因素，以及评估和更广泛传播的策略。包括新技术传播取得影响的显著例子。
采用节俭和负责任的创新原则，并使评估和开发与高标准科学保持一致，有助于克服全球外科学技术传播中的一些挑战。有效传播的典范包括低成本腹腔镜、无气腹腔镜技术和腹腔镜手术创新培训计划；用于骨折的低成本多功能外固定装置；LifeBox 脉搏血氧计项目；以及沉浸式技术在模拟、培训和外科护理方面的应用。
促进全球外科学技术传播的核心策略包括利用国际资金、涉及所有主要利益相关者的跨学科合作以及节俭的科学设计、开发和评估。
