Implementation of laparoscopy surgery training via simulation in a low-income country

Abstract Objective The objective of this study was to evaluate laparoscopy training using pelvitrainers for gynaecological surgeons in a low-income country. Methods The study was carried out in Madagascar from April 2016 to January 2017. The participants were gynaecological surgeons who had not previously performed laparoscopy. Each surgeon was timed to evaluate the execution times of four proposed exercises, based on the fundamentals of laparoscopic surgery (FLS) programme's skills manual, as follows: exercise 1, involving a simple object transfer; exercises 2 and 3, comprising complex object transfers; and exercise 4, a precision cutting exercise. The 8-month training and evaluation programme was divided into different stages, and the four following evaluations were compared: a pretest (T0), assessment at the end of the first training (T1) and auto-evaluation at 2 months (T2) and 8 months (T3). Results Eight participants were included. The median time was significantly reduced ( P P  = 0.07). After 8 months of training, all participants progressed in all exercises. Conclusion Our study showed that it is possible and beneficial to develop a programme for teaching laparoscopic surgery in low-income countries before providing the necessary equipment.