A Review of Remote Surgical Technologies and Training Strategies in Low- and Middle-Income Countries

Access to safe and timely surgical care remains a major challenge in low- and middle-income countries (LMICs), where health systems are often limited by inadequate infrastructure, workforce shortages, and financial constraints. Despite representing a large share of the global population, LMICs perform only a small proportion of the surgical procedures required to meet their health care needs.

This narrative review examines global disparities in surgical access and evaluates current promising strategies to improve surgical capacity in resource-limited settings.

Telemedicine and telesurgery, supported by virtual and augmented reality, enable remote consultation, mentorship, and follow-up care. Simulation-based training has also emerged as a valuable tool for developing both technical and behavioral skills among surgical trainees. While international missions have provided short-term support, they often lack continuity and sustainability. In contrast, locally driven programs that focus on mentorship, digital infrastructure, and training are more likely to produce lasting results. However, challenges remain, including unreliable internet connections, high equipment costs, and the absence of standardized guidelines and data systems.

Overcoming these barriers will require coordinated efforts among governments, academic institutions, and nongovernmental organizations, with a focus on equitable, affordable, and locally appropriate solutions. Strengthening surgical systems in LMICs is essential for reducing global health inequities and meeting broader development goals.