Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana

Background: Healthcare equipment funded by international partners is often not properly utilized in many developing countries due to low levels of awareness and a lack of expertise. A long-term on-site training program for laparoscopic surgery was established at a regional hospital in Ghana upon req...

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Autores principales:	Mee Joo Kang, Kwabena Breku Apea-Kubi, Kojo Assoku Kwarko Apea-Kubi, Nyabenda-Gomwa Adoula, James Nii Noi Odonkor, Alfred Korbia Ogoe
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/72a5ac1614f348409a819da7022a6a91
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spelling	oai:doaj.org-article:72a5ac1614f348409a819da7022a6a912021-12-02T12:21:19ZEstablishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana2214-999610.5334/aogh.2957https://doaj.org/article/72a5ac1614f348409a819da7022a6a912020-07-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2957https://doaj.org/toc/2214-9996Background: Healthcare equipment funded by international partners is often not properly utilized in many developing countries due to low levels of awareness and a lack of expertise. A long-term on-site training program for laparoscopic surgery was established at a regional hospital in Ghana upon request of the Ghana Health Service and local surgeons. Objective: The authors report the initial 32-month experience of implementing laparoscopic surgery focusing on the trainees’ response, technical independence, and factors associated with the successful implementation of a “new” surgical practice. Methods: Curricular structure and feedback results of the trainings for doctors and nurses, and characteristics of laparoscopic procedures performed at the Greater Accra Regional Hospital between January 2017 and September 2019 were retrospectively reviewed. Findings: Comprehensive training including two weeks of simulation workshops followed by animal labs were regularly provided for the doctors. Among the 97 trainees, 27.9% had prior exposure in laparoscopic surgery, 95% were satisfied with the program. Eleven nurses attained professional competency over 15 training sessions where none had prior exposure to laparoscopic surgery. Since the first laparoscopic cholecystectomy in February 2017, 82 laparoscopic procedures were performed. The scope of the surgery was expanded from general surgery (n = 46) to gynecology (n = 33), pediatric surgery (n = 2), and urology (n = 1). The volume of local doctors as primary operators increased from 0% (0/17, February to December 2017) to 41.9% (13/31, January to October 2018) and 79.4% (27/34, November 2018 to September 2019), with 72.5% of the cases being assisted by the expatriate surgeon. There were no open conversions, technical complications, or mortalities. Local doctors independently commenced endoscopic surgical procedures including cystoscopies, hysteroscopies, endoscopic neurosurgeries and arthroscopies. Conclusion: Sensitization and motivation of the surgical workforce through long-term continuous on-site training resulted in the successful implementation of laparoscopic surgery with a high level of technical independence.Mee Joo KangKwabena Breku Apea-KubiKojo Assoku Kwarko Apea-KubiNyabenda-Gomwa AdoulaJames Nii Noi OdonkorAlfred Korbia OgoeUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Mee Joo Kang Kwabena Breku Apea-Kubi Kojo Assoku Kwarko Apea-Kubi Nyabenda-Gomwa Adoula James Nii Noi Odonkor Alfred Korbia Ogoe Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
description	Background: Healthcare equipment funded by international partners is often not properly utilized in many developing countries due to low levels of awareness and a lack of expertise. A long-term on-site training program for laparoscopic surgery was established at a regional hospital in Ghana upon request of the Ghana Health Service and local surgeons. Objective: The authors report the initial 32-month experience of implementing laparoscopic surgery focusing on the trainees’ response, technical independence, and factors associated with the successful implementation of a “new” surgical practice. Methods: Curricular structure and feedback results of the trainings for doctors and nurses, and characteristics of laparoscopic procedures performed at the Greater Accra Regional Hospital between January 2017 and September 2019 were retrospectively reviewed. Findings: Comprehensive training including two weeks of simulation workshops followed by animal labs were regularly provided for the doctors. Among the 97 trainees, 27.9% had prior exposure in laparoscopic surgery, 95% were satisfied with the program. Eleven nurses attained professional competency over 15 training sessions where none had prior exposure to laparoscopic surgery. Since the first laparoscopic cholecystectomy in February 2017, 82 laparoscopic procedures were performed. The scope of the surgery was expanded from general surgery (n = 46) to gynecology (n = 33), pediatric surgery (n = 2), and urology (n = 1). The volume of local doctors as primary operators increased from 0% (0/17, February to December 2017) to 41.9% (13/31, January to October 2018) and 79.4% (27/34, November 2018 to September 2019), with 72.5% of the cases being assisted by the expatriate surgeon. There were no open conversions, technical complications, or mortalities. Local doctors independently commenced endoscopic surgical procedures including cystoscopies, hysteroscopies, endoscopic neurosurgeries and arthroscopies. Conclusion: Sensitization and motivation of the surgical workforce through long-term continuous on-site training resulted in the successful implementation of laparoscopic surgery with a high level of technical independence.
format	article
author	Mee Joo Kang Kwabena Breku Apea-Kubi Kojo Assoku Kwarko Apea-Kubi Nyabenda-Gomwa Adoula James Nii Noi Odonkor Alfred Korbia Ogoe
author_facet	Mee Joo Kang Kwabena Breku Apea-Kubi Kojo Assoku Kwarko Apea-Kubi Nyabenda-Gomwa Adoula James Nii Noi Odonkor Alfred Korbia Ogoe
author_sort	Mee Joo Kang
title	Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
title_short	Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
title_full	Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
title_fullStr	Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
title_full_unstemmed	Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana
title_sort	establishing a sustainable training program for laparoscopy in resource-limited settings: experience in ghana
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/72a5ac1614f348409a819da7022a6a91
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Establishing a Sustainable Training Program for Laparoscopy in Resource-Limited Settings: Experience in Ghana

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