Tele-mentoring for the development of laparoscopic surgery in Zambia

Non-communicable diseases (NCDs), such as cancer, cardiovascular disease and trauma contribute to 29% of all deaths in Zambia, and, according to the World Health Organisation, these numbers are increasing. Surgical care represents a cost-effective and cross-cutting intervention that can address one third of the burden of disease relating to NCDs but continues to be a neglected area for investment in low and middle-income countries.

In high income countries like the UK, minimally invasive surgery, including laparoscopy, is the gold standard approach to the diagnosis and treatment of many common conditions. The approach would be game-changing in countries like Zambia, where limited resources make it challenging to manage open surgery.

Laparoscopy (keyhole surgery) has considerable advantages compared to open surgery. These include decrease in infection and blood loss, reduction in postoperative pain, shorter recovery time for patients, and fewer long-term complications. Additionally, laparoscopy can be used to diagnose tuberculosis, intra-abdominal malignancies, trauma injuries, and pelvic inflammatory disease.

Collaborating with surgeons at Ndola Teaching Hospital

Ndola Teaching Hospital is the main tertiary referral hospital in the North of Zambia, and is striving to be a centre of excellence, providing high quality care, training and research.

At Ndola Teaching Hospital, there are five consultants currently trained in laparoscopic cholecystectomy (gallbladder removal) and ten trainees. Gallbladder removal is a very common procedure, however, the surgeons at the hospital — led by Dr Seke Kazuma, who is also the President of the Surgical Society of Zambia — describe the gallbladder operations that they do as challenging, as the patients who undergo operations have often had severe symptoms for a long time. The surgeons are keen to improve their skills with these operations and to expand their competence in other areas of laparoscopic and endoscopic surgery.

Expert volunteers from King’s College Hospital have started to develop a curriculum covering essential skills in laparoscopic surgery/laparoscopic cholecystectomy/gastroscopy, and online teaching resources to support the Zambian team. Thanks to a Health Education England-funded THET grant, we have worked with engineers to install a bespoke audio-visual tele-mentoring link. 

The link will allow surgeons in London to observe live laparoscopic surgery in Ndola and support learning among the Zambian surgeons as they develop their skills. The tele-mentoring link will enable the Ndola team to grow their confidence and skills, with huge potential benefits for patients in Ndola, as well as offer learning opportunities for the team at King’s College Hospital.