Programme for Training and Research in Laparoscopic Surgery - Dr. P. Meyer - Terms of reference for initiation of collaboration

Programme for Training and Research in Laparoscopic Surgery - Activity report

Programme for Training and Research in Laparoscopic Surgery

with focus on Developing Countries/Countries in Economic Transition

Organised by the
Geneva Foundation for Medical Education and Research,
in collaboration with
WHO/ Department of Essential Health Technologies and Department of Reproductive Health and Research

Coordinator: PD Dr Pierre Meyer

Terms of reference for initiation of collaboration

Background

Laparoscopy has been associated with less minor complications as well as shorter duration of hospital stay when compared to open surgery. It has therefore replaced open surgery for many interventions over the years. However, despite the documented evidence of the benefits and effectiveness, laparoscopy is rarely used in resource-constrained countries. This is often due to restricted availability or access of the equipment and lack of training of medical personnel. In order to address this gap, the Geneva Foundation for Medical Education and Research - in collaboration with WHO/Department of Essential Health Technologies and Department of Reproductive Health and Research - has set out to develop a programme for training and research in laparoscopic surgery with the aim to improve the use of laparoscopy in developing countries. Among the planned activities are the development of a manual in laparoscopy, conduction and evaluation of training programmes, assessment of research needs as well as performance of research programmes.

Purpose

To perform a situation analysis of the implementation status of laparoscopy in selected countries that not only provides a detailed overview but also convincing evidence of the cost-effectiveness of laparoscopy at different levels (i.e. primary, secondary, tertiary level) of the health care system

As there will be great variations among and within countries in using laparoscopy and also in the barriers to its wider implementation, a detailed situation analysis as a first step is essential for appropriate, country- specific activities. The universally applicable Framework for Assessment will greatly facilitate this process. More importantly, the documentation of the cost-effectiveness of laparoscopy (hence the benefits resulting from initial investments that are necessary to introduce laparoscopy at larger scale) is key to achieving acceptance among governments (i.e. MoH) and other decision makers in national health care systems.

Specific points

In order to arrive at the envisaged situation analysis, the GFMER recommends that the collaborating institution performs a study that includes the following:

Assessment of the current status of laparoscopy at different levels of care
Evaluation of feasibility of introducing/improving laparoscopy at the primary and secondary level of the health care system
Assessment of current literature/publications on laparoscopy in the respective country or region, including identification of further research needs
Lessons learned/ recommendations for steps needed to successfully implement laparoscopy at various levels
A detailed cost-effectiveness analysis for introducing laparoscopy at different levels (if applicable) of health care

Table 1 provides more details to the points listed above.

Main points	Details
1. Current status of laparoscopy at different levels of care
A. Performance of intervention*	Type of hospital, at which level of care
	Number of interventions per hospital
	Type of interventions/indications
	Staff involved (i.e. qualification, number)
B. Training*	Existence of training (y/n)
	Place
	Organization
	Content and duration
	Prerequisites for participation
	Credentials acquired
	Financing/cost
2. Feasibility of introducing/improving laparoscopy at the primary and secondary level of the health care system
A. Performance of intervention*	Existence at primary/secondary level (y/n)
	Barriers to introducing/improving intervention
	Current indications and their criteria for intervention at those levels
B. Current plans for future	Existing plans for introduction of intervention
B. Current plans for future	Envisaged indications
3. Current literature/publications on laparoscopy
	Systematic reviews
	Quality and issues discussed
	Further needs in research
4. Lessons learned/ recommendations
Organisation	Level of planning and coordination
Organisation	Collaboration with partners/MoH
Cost-effectiveness	Critical assessment providing arguments for introduction of intervention
Other	Any other useful experiences/ issues

*Note: Points 1A, 1B and 2A are assessed with help of a detailed Framework for Assessment

Contacts at GFMER for the Programme

Prof. Aldo Campana, Dr. Pierre Meyer, Dr. Regina Kulier, Dr. Annette Reinisch (Annette.Reinisch@gfmer.ch)

Text prepared by Annette Reinisch

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Edited by Aldo Campana,