The Successful Implementation of a Laparoscopic Simulation Training Program in the Dominican Republic

Area of Science:

• Global Surgery
• Medical Education Technology
• Surgical Simulation

Background:

• Mount Sinai Hospital established a laparoscopic surgery simulation center in a Dominican Republic hospital.
• The initiative aimed to assess the feasibility of surgical training programs in low-and-middle income countries (LMICs).

Purpose of the Study:

• To determine the feasibility of implementing and sustaining laparoscopic surgical simulation training in a resource-limited setting.
• To evaluate the impact of simulation training on surgical residents' skills in a public hospital in Santiago, Dominican Republic.

Main Methods:

• A simulation center with three stations was established at Hospital Jose Maria Cabral y Báez.
• General surgery residents practiced 1 hour weekly, guided by a senior resident from Mount Sinai.
• Data collected over 10 months included self-reported practice hours and performance on simulated laparoscopic tasks (peg-transfer, precision cutting, intracorporeal knot tying).

Main Results:

• 85% of residents participated, averaging 25 hours of practice over 10 months.
• Significant improvements were observed in precision cutting (P=0.002) and intracorporeal knot tying (P=0.037) times.
• No significant difference in peg-transfer times or performance was noted between resident years (P=0.12).

Conclusions:

• Laparoscopic simulation programs can be successfully integrated into LMIC surgical residency training.
• With institutional commitment and external support, simulation centers are feasible and scalable for improving surgical skills in LMICs.