LaparoscopiX: Expanding Minimally Invasive Surgery

Surgically treatable diseases account for 11% of the world’s burden of disease. However only 3.5% of surgeries happen in low-income countries where laparoscopic surgery – which is minimally invasive surgery through a camera – is scarce. In higher income countries, such as the United States, laparoscopic surgery has dominated since the 90s, primarily due to its improved outcomes. However, there is a lack of trained mentors available in LIMCs to train surgeons in laparoscopic surgery. Moreover, for countries such as Kenya, where 85% of the population is employed informally and approximately 62% are farm laborers, the benefits of laparoscopic surgery are even more important, offering a way to improve recovery time and decrease the risk of complications that cause rehospitalization, disability and death. For patients who rely on everyday labor for subsistence, not having access to laparoscopic surgery increases economic loss and poor health outcomes.

Therefore, our team has developed LaparoscopiX, a novel training paradigm that targets training barriers such as limited mentor availability, expensive training simulators, long learning curves, and inadequate independent training methods. Our proposed paradigm shift in laparoscopic surgical training includes faster skill acquisition with high-frequency, low-dose training exercises. LaparoscopiX contains two main components based on the apprenticeship learning model. The first is an observational component that uses pattern recognition to teach anatomy and surgical planes in real-life situations, and the second is a practical element to gain the skills to perform 3D tasks while referencing a 2D screen. We hypothesize that if surgeons in Kenya have a way to reduce the learning curve associated with going from training to live laparoscopic surgery, they can decrease the number of cases needed with a mentor to gain competency, thus making it possible to train more surgeons and expand access to laparoscopic surgery.