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Expanding Laparoscopic Simulation in Uganda (2024-2025)

This team set out to address the challenge of limited access to surgical training tools in low- and middle-income countries (LMICs). In high-income countries, trainees use costly laparoscopic simulators, or box trainers, to practice fundamental skills before performing operations. This project aimed to develop and validate a low-cost, locally manufactured alternative, called the KeyTrainer, to equip Ugandan medical students and surgical residents with essential laparoscopic skills and ultimately improve patient outcomes. 

Over the past year, the team collaborated with engineering and surgical colleagues at Makerere University in Uganda to adapt simulator models to local contexts. During the summer of 2024, Duke and Ugandan students worked together in Kampala to build prototypes using market-sourced materials and conducted field testing with Ugandan trainees. The Team analyzed testing data to demonstrate construct validity of the KeyTrainer, demonstrating that the laparoscopic simulators could detect different skill levels. Their findings have been submitted to the Journal of Surgical Education and presented at conferences in Zimbabwe and Rwanda.

To further validate the device, students recreated the KeyTrainer at Duke University and tested it against high-cost commercial simulators in the Duke Surgery Education and Activities Lab. Data collection is ongoing to determine whether the KeyTrainer performs at least as effectively as standard models, with results expected to be presented at the American College of Surgeons and submitted to the Journal of the American College of Surgeons. Looking ahead, the design is under review with a Ugandan manufacturer to enable large-scale local production, a step that could expand affordable surgical training opportunities across LMICs.

Timing

Summer 2024 – Summer 2025

Team Outputs

Development and Validation of Ugandan-Made Laparoscopic Box Training (Poster presentation at the Fortin Foundation Bass Connections Showcase, April 16, 2025)

KeyTrainer prototype

Publication under review – Journal of Surgical Education

Presentation at the College of Surgeons of Central, East, Southern Africa, Zimbabwe, December 2024

Presentation at the Pan-African Surgical Conference, Rwanda, February 2025

See earlier related team Sustainable Implementation of Laparoscopy in Low-income Countries (2021-2022).

Team Leaders

  • Shannon Barter, School of Medicine: Surgery
  • Tamara Fitzgerald, School of Medicine: Surgery: Pediatric General Surgery
  • Ann Saterbak, Pratt School of Engineering, Pratt School of Engineering: Biomedical Engineering

Undergraduate Team Members

  • Rania Challita, Biomedical Engineering (BSE)
  • Kimi Du, Biomedical Engineering (BSE)
  • Wigdan Hissein, Psychology (BS); Global Health (AB2)
  • Chimdi Ikpe, Biology (BS)
  • Anna McPherson, Chemistry (AB); Global Health (AB2)
  • Arushi Sivasankar, Biomedical Engineering (BSE)
  • Saanvee Sunkara, Biomedical Engineering (BSE)

Community Team Members

  • Rebecca Kaaya, Makerere University
  • Paula Kworekwa, Makerere University
  • Samantha Lindak, Makerere University
  • Julius Mugaga, Makerere University - Kampala
  • Robert Ssekitoleko, Makerere University-Kampala
  • Mark Tugume, Makerere University
  • Patricia Tukuri, Makerere University
  • Kato Hussein Wabbi, Makerere University

Team Contributors

  • Anthony Eze, School of Medicine: Surgery
  • Olivia McGinnis, School of Medicine: Surgery