2025 Proffered Presentations
S137: HOW TO ESTABLISH MICROSURGERY LABORATORY TRAINING IN LMICS: AN EXPERIENCE IN 35 CENTERS ACROSS 20 LMICS
Abdullah Keles, MD; Huseyin E Ak, MD; Mustafa K Baskaya, MD; Department of Neurological Surgery University of Wisconsin School of Medicine and Public Health
Background: Microsurgical training is essential for healthcare professionals in low- and middle-income countries (LMICs) to improve surgical outcomes and patient care. To address the disparity in training opportunities, a comprehensive initiative was launched in 2020 to provide free, accessible, and sustainable microsurgery training within LMICs. This initiative combines the donation of basic and advanced microsurgery training kits with offline, live-streamed, and in-person assistance.
Objective: To present the experience and outcomes of establishing microsurgery laboratory training in 35 centers across 20 LMICs and to share the impact on enhancing surgical skills and capacity in these regions.
Methods: The initiative implemented a structured program that included:
Development and distribution of basic and advanced microsurgery training kits (Figure 1) using consumer tweezers.
Figure 1: Basic and advanced microsurgery training sets.
Donation of 80 tabletop stereo microscopes and 7 Zeiss OPMI microscopes.
Organization of no-cost hands-on courses in microvascular anastomosis, with a focus on neurosurgery, general surgery, orthopedics, and plastic surgery.
Training sessions were delivered through various methods:
Offline training database sharing to enable self-training at each location.
Online live-streamed sessions and recorded tutorials for remote learning (Figure 2).
Figure 2: Online live-streamed sessions conducted in our neurosurgery operative skills laboratory with colleagues from LMICs connected via online platforms.
On-site courses conducted in countries like Turkey, Georgia, Azerbaijan, Paraguay, and Mexico (Figure 3).
Figure 3: On-site hands-on microvascular anastomosis practice session with neurosurgeons.
Results: Microsurgery laboratory training was established in 36 centers, 20 LMICs across four continents; Africa, Asia, South America, and North America (Figure 4).
Figure 4: Global distribution of 87 microscopes to 36 centers in 20 LMICs across Africa, Asia, South America, and North America.
Offline training videos were shared with each institution. The distribution of training materials and microscopes enabled continuous practice and skill retention at their home institutions. Over 200 participants from multiple surgical specialties were trained in the no-cost hands-on microvascular anastomosis slingshot program. Ten live-streamed sessions were organized with over 80 participants.
Discussion: The success of our program highlights the effectiveness of combining low-cost, high-impact training tools with comprehensive support and mentorship. The initiative's scalability and adaptability make it a viable model for expanding surgical training in resource-limited settings. Key challenges included logistical coordination, cultural differences, and ensuring sustainability. Future directions involve expanding the program to additional LMICs.
Conclusion: We successfully established a sustainable and impactful model for microsurgical training in LMICs. Our initiative not only improves the surgical skills of participants but also contributes to building local capacity for advanced surgical care. Sharing this experience can inspire and guide similar efforts globally, ultimately enhancing surgical outcomes and patient care in underserved regions.