Nyundo Martin, Umugwaneza Nathalie, Bekele Abebe, Chikoya Laston, Detry Olivier, Gashegu Julien
Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda.
Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda.
J Surg Educ. 2023 Oct;80(10):1454-1461. doi: 10.1016/j.jsurg.2023.07.024. Epub 2023 Aug 22.
The resource-limited environment in Sub-Saharan countries, with a lack of expert trainers, impedes the progress of laparoscopic training. This study aimed to identify the opportunities and limitations of laparoscopic surgery training in the College of Surgeons of East, Central, and Southern Africa (COSECSA) countries.
A multicountry online survey was conducted from January 2021 to October 2021 in COSECSA-accredited training hospitals within 16 countries. Available resources and challenges faced in order to set up well-structured laparoscopic training programs were explored.
Ninety-four surgeons answered the questionnaire. The average resources reported per hospital were 3 trained laparoscopic surgeons, 2 laparoscopic towers, and 2 sets of laparoscopic instruments. The training of the majority of these surgeons has been in local institutions (53%), a further 37% within African countries and only 10% outside Africa. Approximately 45% of them declared that laparoscopic modules were planned within the University Curricula, while only 18% of surgeons recognized that laparoscopic modules are only planned within the COSECSA program. About 57% of participants reported that at the end of residency training, graduating surgeons were not able to perform basic laparoscopic procedures. The quoted barriers included: limited laparoscopic equipment, absence of simulation lab, lack of qualified trainers, lack of training programs and time for teaching by skilled doctors, and lack of institutional support.
The well-structured set up of laparoscopic training programs in the COSECSA region is hindered due to the lack of qualified personnel and insufficient resources for the acquisition of equipment and simulation laboratories. Ongoing efforts to set up laparoscopic programs through the development of adaptive curricula, innovative strategies for reduction of equipment cost and adequate training of surgeons are crucial for patient safety and the development of laparoscopy.
撒哈拉以南国家资源有限的环境以及缺乏专业培训人员，阻碍了腹腔镜培训的进展。本研究旨在确定东非、中非和南非外科医生学院（COSECSA）国家腹腔镜手术培训的机遇和局限性。
2021年1月至2021年10月，在16个国家的COSECSA认可的培训医院开展了一项多国在线调查。探讨了建立结构完善的腹腔镜培训项目所面临的可用资源和挑战。
94名外科医生回答了问卷。每家医院报告的平均资源为3名经过培训的腹腔镜外科医生、2台腹腔镜设备塔和2套腹腔镜器械。这些外科医生中的大多数在当地机构接受培训（53%），另有37%在非洲国家境内，只有10%在非洲境外。约45%的人宣称大学课程中规划了腹腔镜模块，而只有18%的外科医生认识到腹腔镜模块仅在COSECSA项目中规划。约57%的参与者报告称，住院医师培训结束时，毕业外科医生无法进行基本的腹腔镜手术。提到的障碍包括：腹腔镜设备有限、缺乏模拟实验室、缺乏合格的培训人员、缺乏培训项目以及熟练医生的教学时间，以及缺乏机构支持。
由于缺乏合格人员以及购置设备和模拟实验室的资源不足，COSECSA地区腹腔镜培训项目的结构完善设置受到阻碍。通过制定适应性课程、降低设备成本的创新策略以及对外科医生进行充分培训来持续努力建立腹腔镜项目，对于患者安全和腹腔镜技术的发展至关重要。
