Enhancing microsurgical skills in neurosurgery residents of low-income countries: A comprehensive guide

Background: The main objectives of this paper are to outline the essential tools, instruments, and equipment needed to set up a functional microsurgery laboratory that is affordable for low-income hospitals and to identify cost-effective alternatives for acquiring microsurgical equipment, such as refurbished or donated instruments, collaborating with medical device manufacturers for discounted rates, or exploring local suppliers. Methods: Step-by-step instructions were provided on setting up the microsurgery laboratory, including recommendations for the layout, ergonomic considerations, lighting, and sterilization processes while ensuring cost-effectiveness, as well as comprehensive training protocols and a curriculum specifically tailored to enhance microsurgical skills in neurosurgery residents. Results: We explored cost-effective options for obtaining microsurgery simulators and utilizing open-source or low-cost virtual training platforms. We also included guidelines for regular equipment maintenance, instrument sterilization, and establishing protocols for infection control to ensure a safe and hygienic learning environment. To foster collaboration between low-income hospitals and external organizations or institutions that can provide support, resources, or mentorship, this paper shows strategies for networking, knowledge exchange, and establishing partnerships to enhance microsurgical training opportunities further. We evaluated the impact and effectiveness of the low-cost microsurgery laboratory by assessing the impact and effectiveness of the established microsurgery laboratory in improving the microsurgical skills of neurosurgery residents. About microsutures and microanastomosis, after three weeks of training, residents showed improvement in “surgical time” for ten separate simple stitches (30.06 vs. 8.65 min) and ten continuous single stitches (19.84 vs. 6.51 min). Similarly, there was an increase in the “good quality” of the stitches and the suture pattern from 36.36% to 63.63%. Conclusion: By achieving these objectives, this guide aims to empower low-income hospitals and neurosurgery residents with the necessary resources and knowledge to establish and operate an affordable microsurgery laboratory, ultimately enhancing the quality of microsurgical training and patient care in low-income countries. © 2023 Scientific Scholar. All rights reserved.

Authors
Ovalle Torres C.S. , Mora A.E. , Campero A. , Cherian I. , Sufianov A. , Sanchez E.F. , Ramirez M.E. , Pena I.R. , Nurmukhametov R. , Beltrán M.A. , Juarez E.D. , Cobos A.M. , Lafuente-Baraza J. , Baldoncini M. , Luzzi S. , Montemurro N.
Publisher
Scientific Scholar
Language
English
Status
Published
Number
437
Volume
14
Year
2023
Organizations
  • 1 Department of Neurosurgery, National University of Mexico Hospital General, Durango, Mexico
  • 2 Neurosurgery Service, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
  • 3 Department of Neurosurgery, Hospital Padilla de Tucuman, San Miguel de Tucuman, Tucuman, Argentina
  • 4 Institute of Neurosciences, Krishna Vishwa Vidyapeeth, Maharashtra, Karad, India
  • 5 Department of Neurosurgery, Federal Center of Neurosurgery, Tyumen, Russian Federation
  • 6 Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
  • 7 Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Australia
  • 8 Department of Neurosurgery, RUDN University, Moscow, Russian Federation
  • 9 Neurosurgery Service, Hospital Star Medica, Chihuahua, Mexico
  • 10 Spine Surgery Unit, Department of Neurosurgery, Hospital del Mar, Barcelona, Spain
  • 11 Department of Neurosurgery, San Fernando Hospital, Belgrano, San Fernando, Argentina
  • 12 Department of Neurosurgery, University of Pavia, Pavia, Italy
  • 13 Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
Keywords
Low-income countries; Microsurgery laboratory; Microsurgical skills; Neurosurgery
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