Postgraduate surgical hernia training with a standardized hernia surgery training tool: training while serving humanity

Abstract

The hernia surgery skills training course was first organized in 2016, after approval by the COSECSA (College of Surgeons of East, Central and Southern Africa) Executive at a meeting in Geneva, through representation by Prof. Laston Chikoya, then Chairman of the COSECSA Educational Committee. Uganda was selected as the hub of the training program, and Prof. Ignatius Kakande was charged with the responsibility of organizing it. He has successfully supervised the collaboration with Operation Hernia in organizing this course.

The Operation Hernia UK-COSECSA Training Course is a comprehensive program in groin Hernia surgery and has had over six previous courses, providing residents with an invaluable training opportunity. It is a structured program with integrated competence assessment, delivered on a one-to-one basis. This model, designed by Operation Hernia and Surgeons for Africa, has also been used to train residents in Rwanda. It has been published and can be applied to other surgical specialties[1].

This study elaborates on a hernia surgery skills training program conducted with surgical residents and COSECSA fellow candidates. The training aimed to achieve an appropriate level of competence in mesh and tissue hernia surgery; train residents who complete the course to become trainers, thereby sustaining the program; and expand the program to surgical residents from other COSECSA countries using the Ugandan experience as a model.

The rationale of this training follows the background of the high burden of hernias, where the prevalence of hernias in African countries is high[2,3]. And yet the rate of repair of hernias is low (10–100/100 000) compared to rates in high-income countries[4]. This gap highlights a critical need for enhanced surgical capacity and training in the region. Surgical trainees in African countries do not all have access to didactic structured training with competence assessment[1]. Addressing this training deficit is essential to improve surgical outcomes and meet the demand for hernia repairs across these populations.