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Enhancing Surgical Capacity in Low to Middle-Income Countries: An Initiative Study of Global Surgery Experience in Pediatric and Reconstructive Urology

L. Aba¹, M. Chua², K. Rivera², M. See IV³, A. Nguyen⁴, M. Rickard², J. Pippi Salle², A. Lorenzo², E. Chong⁵

¹St. Luke's Medical Center, Institute of Urology, Quezon City, Philippines
²The Hospital for Sick Children, Division of Urology, Ontario, Canada
³St. Luke's Medical Center, Institute of Urology, Quezon, Philippines
⁴Vietnam Children Hospital 1, Division of Urology, Ho Chi Minh, Vietnam
⁵Chinese-Filipino Business Club, Inc. (CFBCI), Chinese-Filipino Business Club, Inc. (CFBCI), Binondo, Philippines

Introduction:

Global Surgery in pediatric and adult reconstructive urology plays a critical role in improving healthcare outcomes in low- and middle-income countries (LMICs). Integrating this specialty into global health efforts, mainly through capacity building with innovative educational methods such as mixed-method in-person and piloting the augmented reality (AR)-assisted telementoring, could enhance local surgical capacities. We aim to evaluate the impact of a Global Surgery Collaborative Project that utilizes both traditional and pilot use of AR-assisted telementoring to train local surgeons in pediatric and reconstructive urology in the Philippines.

Material and methods:

This sequential mixed-methods study assessed the efficacy and sustainability of in-person and AR-assisted remote training programs from 2021 to 2024. Data were collected and summarized for performed case characteristics, surgical information and peri-operative outcomes, mentee comfort levels, and technical understanding, which were analyzed pre to post-mentoring differences using paired t-tests.

Results:

A total of 38 major surgical cases were undertaken, with appropriate operative times and acceptable postoperative outcomes noted over the study period. Mentees demonstrated substantial gains in comfort and technical knowledge, with statistically significant improvements in both domains (p < 0.001). The pilot use of AR-assisted telementoring showed feasibility and safety in global surgery initiative training effectiveness and surgical precision.