A Pilot for Surgical Education in Low-and Middle-Income Countries: Establishing a Basic Laparoscopic Training Program in Cambodia

Purpose: Nine of 10 people in low- and middle-income countries (LMICs) such as Cambodia do not have access to safe, affordable surgical and anesthesia care. This disparity is exacerbated by a lack of proper training opportunities for surgeons to further specialize in areas like minimally invasive surgery. The principal objective of this study was to develop and establish a sustainable basic laparoscopic surgery training program starting at Calmette Hospital in Phnom Penh, Cambodia and expanding to two regional hospitals in more rural areas. This model may be employed for use in other LMICs. Methods: Between 2022 and 2023, a comprehensive basic laparoscopy training program was implemented across three Cambodian hospitals: Calmette, Kampong Cham, and Kampong Thom. The curriculum included didactic lectures, simulation-based exercises, and practical in-theatre experience. Local educators were trained to perpetuate the program. A total of 59 participants, including 36 attending physicians and 23 trainees, completed the training. Pre- and post-training surveys were deployed to assess skill improvement and confidence; paired t-tests were used to analyze performance across laparoscopic simulation tasks. Results Participants demonstrated significant improvements in laparoscopic skills, with reduced task completion times and improved accuracy (p < 0.05). Post-training surveys revealed that 85% of learners continued practicing their skills, and most reported increased confidence in performing laparoscopic procedures. Attending physicians and trainees benefited equally. Conclusions This model provides a standardized and replicable platform with theoretical, practical, and evaluation components for expanding access to self-sustained MIS training in LMICs such as Cambodia.