Designing a dual-approach model to teach surgeons how to perform laparoscopic treatment of ectopic pregnancies
ALL-SAFE, African Laparoscopic Learners – Surgical Advancement For Ectopic pregnancy, is designing a surgical training model to provide surgeons with the necessary skills and confidence to perform laparoscopic treatment of ectopic pregnancy in resource-constrained settings. The team will develop a two-fold approach, leveraging Web-based learning with psychomotor skills training in a simulation model that mimics the pelvic anatomy.
Team Co-Leads: Dr. David Jeffcoach and Dr. Grace Kim
Lead Institution: Soddo Christian Hospital in Ethiopia
Team Countries: Ethiopia, Cameroon, Kenya
“Our model unifies content within the context of a clinical case that takes the learner from first encounter with a patient to diagnosis and through post-operative recovery.”
What does the module do?
Their model is based on two components — one web-based that targets decision-making and a second that addresses psychomotor skills. The team is designing a model that makes use of easily accessible materials to simulate pelvic anatomy.
The entire module guides learners from initial diagnosis through post-operative recovery. ALL-SAFE builds on traditional laparoscopic training needs. In addition to self-assessment, learners will be able to share results with a global community of practice, thus receiving further feedback from peers and experts.
“Although the materials are low-cost, the fundamental elements maintain a high fidelity that conceptually aligns with high-cost simulators available in high-income countries,” says Dr Jeffcoach.
What inspired this module?
Ectopic pregnancy, when a fertilized egg implants and grows outside the main cavity of the uterus, affects approximately two percent of pregnancies around the world. It is the leading cause of maternal death, and a significant contributor to infertility in women. Women in sub-Saharan Africa have an increased risk of ectopic pregnancy, with little or no access to minimally invasive, laparoscopic interventions.
To address this need, the ALL-SAFE team is developing a module to teach all aspects of patient care in the laparoscopic treatment of ectopic pregnancy.
“Though most patients in low- and middle-income countries present at a more advanced stage that might necessitate an open approach, a large cohort of patients may benefit from a less invasive technique,” says team lead Dr David Jeffcoach, who is program director of the general surgery residency program at Soddo Christian Hospital in Ethiopia.
A study published in the World Journal of Surgery showed that the lack of trainers, training equipment, and simulation — not cost or lack of equipment — is the greatest barrier towards the implementation of laparoscopy. By training surgeons, gynecologists and surgical and medical residents, ALL-SAFE hopes to address the shortage of professionals who are qualified to address this critical need.
The benefits of laparoscopic management of ectopic pregnancy have been well established. The procedure has a significantly shorter operation time, less perioperative blood loss, reduced risk of infection, and a shorter convalescence time compared to its open counterpart.
