EN
TÜRKÇE
Poster - 345
Unmasking the challenges: a qualitative study of barriers to training pediatric surgeons in minimally invasive surgery in Pakistan
Batool Fatima, Zahra Auqil, Zuha Zafar, Kashif Bashir
Department of Pediatric Surgery, Mayo Hospital Lahore, Pakistan
Purpose
Minimally invasive surgery (MIS) has become a cornerstone of modern pediatric surgical care, offering reduced postoperative pain, quicker recovery, and improved outcomes. However, in low- and middle-income countries (LMICs) like Pakistan, pediatric MIS integration lags that of adult MIS, with training limitations contributing significantly to this disparity. We tried to explore the barriers faced by pediatric surgeons in acquiring and teaching MIS skills in Pakistan, with the goal of informing practical, context-specific improvements in surgical training.
Methods
This qualitative study was conducted in pediatric surgery departments of major teaching hospitals across Pakistan. Fifteen pediatric surgeons, including both MIS-trained experts and senior surgeons still learning MIS techniques, were selected through purposive and snowball sampling. Data was collected via semi-structured interviews using a thematic guide. Transcripts were coded, and thematic analysis was performed to identify recurring patterns and insights.
Results
Four major themes were identified:
1. Infrastructure and Equipment Gaps: Unavailability of pediatric-specific instruments in public sector teaching hospitals and limited access to dry labs like simulators and robotics.
2. Training and Mentorship Deficiencies: Lack of formalized MIS curricula and limited exposure in residency. Senior surgeons acknowledged their own limited MIS experience, creating a training bottleneck.
3. Institutional and Policy-Level Barriers: Absence of national-level pediatric MIS training mandates. Training abroad is self-funded, with no government-level scholarships and grants for advanced learning opportunities.
4. Sociocultural and Ethical Challenges: Ethical concerns over training on pediatric patients without adequate supervision and certification.
Conclusion
Pediatric MIS training in Pakistan is hindered by systemic, infrastructural, and educational challenges. Developing structured national curricula, investing in training tools, fostering mentorship networks, and promoting faculty development are essential steps toward bridging the MIS training divide in LMICs.