Journal – JTCVS Open
Article type – Journal research article – Clinical research
Publication date – Dec – 2022
Authors – Adom Bondzi-Simpson, Melanie Keshishi, Yonas Ademe, Marci Rose, Ayalew Tizazu, Sameena Uddin, Michael Ko
Keywords – Ethiopia, global surgical education, minimally invasive surgery (MIS)
Open access – Yes
Speciality – General surgery, Surgical education
World region Eastern Africa
Country: Ethiopia
Language – English
Submitted to the One Surgery Index on December 13, 2022 at 12:46 am
Abstract:

Objective
Complex lung diseases are among the leading causes of death in Ethiopia. Access to thoracic surgery is limited and prior to 2016 no thoracic surgeons were trained in minimally invasive surgery (MIS). A global academic partnership was formed between the University of Toronto and Addis Ababa University (AAU). Here, we describe implementation of the first MIS training program in sub-Sahara Africa and evaluate its safety.
Methods
Retrospective cohort analysis of open versus minimally invasive thoracic and upper gastrointestinal procedures performed at AAU from January 2016, to June 2021. Baseline demographic, diagnostic, operative, and post-operative outcomes including length of stay (LOS) and complications were compared.
Results
In our bilateral model of surgical education, training is provided in Ethiopia and Canada over two years with focus on capacity building through egalitarian forms of knowledge exchange. Program features included certification in Fundamentals of Laparoscopic Surgery®, high-fidelity lobectomy simulation and hands on training. Overall, 41 open and 56 MIS cases were included in final statistical analysis. The average LOS in the MIS group was 5.2 days versus 11.0 days in the open group (p-value <0.001). The overall complication rate was 18% in the MIS group versus 39% open (p-value 0.020).
Conclusions
Here we demonstrated the successful initiation of sub-Sahara Africa’s first MIS program in thoracic and upper gastrointestinal surgery and characterize its patient safety. We envision the MIS program as a template to continue expanding global partnerships and improving surgical care in other resource-limited settings.

OSI Number – 21839

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