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海地新型腹腔镜妇科课程的经验:实施中的教训。

Experience with a novel laparoscopic gynecologic curriculum in Haiti: lessons in implementation.

机构信息

Division of Minimally Invasive Gynecology, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, 1161 21st Ave South, B-1100 Medical Center North, Nashville, TN, 37232-2521, USA.

Global Health Section, Department of Obstetrics & Gynecology, Vanderbilt University Medical Center, Nashville, USA.

出版信息

Surg Endosc. 2020 May;34(5):2035-2039. doi: 10.1007/s00464-019-06983-9. Epub 2019 Jul 22.

DOI:10.1007/s00464-019-06983-9
PMID:31332562
Abstract

BACKGROUND

An estimated one-third of the world's burden of disease requires surgical treatment. In many high-income nations, a large proportion of critical surgical procedures are performed laparoscopically due to a number of advantages the technique offers. There is forward progress in the global surgery field to increase access to laparoscopic techniques in low and middle-income settings (LMIC), with potential benefits to both patients and surgeons.

METHODS

A week long laparoscopic surgery curriculum for surgeons and hospital staff was designed and implemented in a low-resource setting. An iterative design was used to adapt the curriculum on the ground.

RESULTS

The local laparoscopic team was able to independently perform two laparoscopic procedures since the course was administered.

CONCLUSIONS

Implementing laparoscopic surgery programs may be feasible in many LMIC settings. Access to this care may benefit patients. Lessons learned for the global laparoscopist are described.

摘要

背景

全球约有三分之一的疾病负担需要手术治疗。在许多高收入国家,由于该技术具有许多优势,大量的关键手术都是通过腹腔镜进行的。全球外科领域正在取得进展,以增加在中低收入国家获得腹腔镜技术的机会,这对患者和外科医生都有潜在的好处。

方法

在资源匮乏的环境中,为外科医生和医院工作人员设计并实施了为期一周的腹腔镜手术课程。在实地采用迭代设计来调整课程。

结果

自课程实施以来,当地的腹腔镜团队已经能够独立进行两项腹腔镜手术。

结论

在许多中低收入国家,实施腹腔镜手术项目可能是可行的。提供这种治疗可能使患者受益。描述了全球腹腔镜医师的经验教训。

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Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries.全民健康覆盖时代低质量卫生系统导致的死亡:137 个国家可避免死亡的系统分析。
Lancet. 2018 Nov 17;392(10160):2203-2212. doi: 10.1016/S0140-6736(18)31668-4. Epub 2018 Sep 5.
2
Using a Mobile Smartphone to Perform Laparoscopy.使用移动智能手机进行腹腔镜检查。
J Minim Invasive Gynecol. 2018 Jul-Aug;25(5):912-915. doi: 10.1016/j.jmig.2017.12.027. Epub 2018 Feb 6.
3
Practice, training and safety of laparoscopic surgery in low and middle-income countries.
低收入和中等收入国家腹腔镜手术的实践、培训与安全性
World J Gastrointest Surg. 2017 Jan 27;9(1):13-18. doi: 10.4240/wjgs.v9.i1.13.
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Advancement of laparoscopic surgery in Guyana: a working model for developing countries.圭亚那腹腔镜手术的进展:发展中国家的一个工作模式。
Adv Med Educ Pract. 2016 Oct 25;7:605-610. doi: 10.2147/AMEP.S83374. eCollection 2016.
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Global burden of surgical disease: an estimation from the provider perspective.外科疾病的全球负担:从医疗服务提供者角度的估计
Lancet Glob Health. 2015 Apr 27;3 Suppl 2:S8-9. doi: 10.1016/S2214-109X(14)70384-5.
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Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate.根据疾病患病率估算全球手术需求:世卫组织全球卫生估计的建模策略。
Lancet Glob Health. 2015 Apr 27;3 Suppl 2(Suppl 2):S13-20. doi: 10.1016/S2214-109X(15)70087-2.
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Systematic review of laparoscopic surgery in low- and middle-income countries: benefits, challenges, and strategies.低收入和中等收入国家腹腔镜手术的系统评价:益处、挑战与策略
Surg Endosc. 2016 Jan;30(1):1-10. doi: 10.1007/s00464-015-4201-2. Epub 2015 Apr 15.
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World J Surg. 2013 Jan;37(1):14-23. doi: 10.1007/s00268-012-1795-6.