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Pediatric Laparoscopy in low resource settings

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Pediatric Laparoscopy in low resource settings

  1. 1. Pediatric Laparoscopy In Low Resource Settings 12th PAPSA Meeting November 2018 Addis Ababa, Ethiopia
  2. 2. About Me Mah mou d E lfiky, M.D., GCS RT • A ssistant Professor of Ped iatric S u rger y • A lu m Glob al Clin ical Researc h S c h olars Har vard Un i • A d min istrative S ec retar y of IPEG Mid d le East • IT CoChair of IPEG • Web master an d S oc ial Med ia Coord in ator for IPEG & WO FA PS
  3. 3. FR Pediatric Laparoscopy PA ST • Systematic Review of 1,101 abstracts from 25 LMICs • Laparoscopy is advantageous; safe, effective, feasible • Despite challenges; limitations, overbedding, low income, poor sanitation • (Chao, Tiffany E., et al. "Systematic review of laparoscopic surgery in low-and middle- income countries: benefits, challenges, and strategies." Surgical endoscopy 30.1 (2016): 1-10)
  4. 4. FR Pediatric Laparoscopy PR ES E NT • Not widespread in LMICs • (Gyedu et al., 2015; Ekwunife and Nwobe, 2014; Owono, 2008; Chao et al., 2016; Amin et al., 2015; Akintobi et al., 2015). • Inadequate strategy of funding • Lack of adoption of new technology • Surgeons less willing to carry out more technically complicated and time-consuming procedures • (Choy I, Kitto S, Adu-Aryee N et al. Barriers to the uptake of laparoscopic surgery in a lower-middle-income country. Surg Endosc. 2013;27:4009-15)
  5. 5. Pediatric Laparoscopy F UTUR E • Laparoscopic surgery must be a vital component of surgical training in LMICs. • (Klein, Rosemary, and Adrian Park. "Surgical Training in Low-Resource Settings." Global Surgery. Springer, Cham, 2017. 51-67.)
  6. 6. Pediatric Laparoscopy Research
  7. 7. FR Data Collection R ES O URCES OPENEMR • OpenEMR • HIPAA Compliant • Patient Portal • Medical Billing, Inventory, Appointment scheduling • Highly customizable with many integrations • Cloud-based • FREE REDCAP • Research Electronic Data Capture • Secure Web Application • Manages Databases and Surveys • Online & Offline + App • Huge Consortium for collaboration • 3026+ centres • 126+ countries • 576,000+ projects
  8. 8. FRPediatric Surgery Research Collaborations
  9. 9. Pediatric Laparoscopy Education & Training
  10. 10. FR Pediatric Surgery Education & Training O NLINE PLATFO R MS JPS • Journal of Pediatric Surgery • Established 1966 • Official Journal for APSA, CAPS, BAPS,IPEG & PAPS GlobalCastMD • GlobalCastMD • Launched 2014 • FREEMIUM • Case presentations, tutorials, discussions • App + Podcasts • (Ponsky, Todd A., and Steven S. Rothenberg. "Modern, multi-media, advances in surgical information." Seminars in pediatric surgery. Vol. 24. No. 3. WB Saunders, 2015)
  11. 11. FR Pediatric Surgery Education & Training O NLINE PLATFO R MS JLAST • Journal of Laparoendoscopic & Advanced Surgical Techniques • Videoscopy section • Journal for IPEG SSTC • Surgical Skills Training Centre • Established 2011 • University of Cape Town • Endorsed by WOFAPS
  12. 12. FR Pediatric Surgery Education & Training O NLINE PLATFO R MS STEPS • Standardized Toolbox of Education for Pediatric Surgery • Designed by APSA education committee • For junior residents & students WebSurg • Online University of IRCAD • Virtual Surgical University • Over 4000 videos • FREE • Many languages
  13. 13. FR Pediatric Surgery Education & Training O NLINE E DUCATIO N MOODLE • WOFAPS Learning Center • Under Development • Should be available to all Surgeons Worldwide • Open invitation to join • (Krishnaswami, Sanjay, Benedict C. Nwomeh, and Emmanuel A. Ameh. "The pediatric surgery workforce in low-and middle-income countries: problems and priorities." Seminars in pediatric surgery. Vol. 25. No. 1. WB Saunders, 2016) YOUTUBE • IPEG YouTube • Over 600 Videos • Curated from Best Pediatric MIS Surgeons • Tips & Tricks • (Frongia, Giovanni, et al. "YouTube as a potential training resource for laparoscopic fundoplication." Journal of surgical education 73.6 (2016): 1066-1071)
  14. 14. FR Pediatric Surgery Education & Training S CHO LA RS HIPS WOFAPS • International Scholarship • WOFAPS Foundation • offers International Guest Scholarships to competent young pediatric surgeons (less than 40 years old) from developing • Cover Travel expenses and additional support. • Pediatric surgical teaching centers in North America, Europe, Asia and Africa for a clinical observership. Global Paediatric Surgery Network • Fellowships & Funding for Surgeons • British Association of Paediatric Surgeons (BAPS) • Pacific Association of Pediatric Surgeons (PAPS) • American College of Surgeons (ACS) • American Pediatric Surgical Association (APSA)
  15. 15. FR Pediatric Surgery Networks CO NNEC TING S URGEO NS FACEBOOK • IPEG Middle East Chapter • 300+ Members • Case presentations, tutorials, discussions • Established by an IPEG MEC FACEBOOK • The Pediatric Surgeon’s Lounge • 2000 Members • Case presentations, tutorials, discussions • Endorsed by WOFAPS
  16. 16. FR Pediatric Surgery Networks LITE R ATUR E HINARI • Hinari Access to Research for Health Programme • Created by UN’s Secretary General Kofi Annan • Full text • FREE 6 Months - $1000 • For LIC UPTODATE • UpToDate App • Wolters Kluwer Health • For Evidence Based Medicine • iOS and Android • Subscription
  17. 17. Pediatric Laparoscopy Simulators & Tricks
  18. 18. FRMartynov, Illya, and Martin Lacher. "Homemade Glove Port for Single-Incision Pediatric Endosurgery (SIPES) Appendectomy—How We Do It." European journal of pediatric surgery reports 6, no. 01 (2018): e56-e58.
  19. 19. FRDi Saverio, Salomone, et al. "Single-incision laparoscopic appendectomy with a low- cost technique and surgical-glove port:“How To Do It” with comparison of the outcomes and costs in a consecutive single-operator series of 45 cases." Journal of the American College of Surgeons 222.3 (2016): e15-e30.
  20. 20. FRReino-Pires, Pedro, and Manuel Lopez. "Validation of a Low-Cost Do-It-Yourself Model for Neonatal Thoracoscopic Congenital Diaphragmatic Hernia Repair." Journal of surgical education (2018).
  21. 21. FRMaricic, Maximiliano Alejo, María Marcela Bailez, and Susana P. Rodriguez. "Validation of an inanimate low cost model for training minimal invasive surgery (MIS) of esophageal atresia with tracheoesophageal fistula (AE/TEF) repair." Journal of pediatric surgery 51.9 (2016): 1429-1435.
  22. 22. FRCheung, Carling L., et al. "Use of 3-dimensional printing technology and silicone modeling in surgical simulation: development and face validation in pediatric laparoscopic pyeloplasty." Journal of surgical education 71.5 (2014): 762-767.
  23. 23. FRGavrilovic, Bojan, et al. "Development of an Open-Source Laparoscopic Simulator Capable of Motion and Force Assessment: High Tech at Low Cost." Journal of Laparoendoscopic & Advanced Surgical Techniques (2018).
  24. 24. Thank You Mahmoud Elfiky +201001557755 mfiky@kasralainy.edu.eg www.wofaps.org
  25. 25. FR

Hinweis der Redaktion

  • Collaborators will be invited to participate from a wide range of organisations. Any healthcare professional who is involved in the care of infants presenting primarily with congenital anomalies can participate in the study i.e surgeons, anaesthetists, neonatologists, paediatricians, trainees, medical students and nurses. There can be up to 3 collaborators per institution per month of data collection. Hence, there can be more than one team of 3 collaborators collecting data over a different time point between Oct 2018 – April 2019.

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