Building on the Past to Empower the Future: Establishing Microsurgery Training Practice with 100 Kit Donations Across 24 LMICs

Introduction: Even though modern microsurgical techniques were introduced in the late 1960s, they remain largely inaccessible in the majority of low- and middle-income countries (LMICs). The inadequate availability of microsurgical training facilities and medical professionals trained in microneurosurgical techniques is a key factor contributing to the disparity in LMICs when compared to high-income countries.
LMICs are facing a substantial requirement for medical professionals skilled in microsurgical techniques. Madison Microneurosurgery Initiative (MMI) was founded to bridge this gap in microsurgical training by providing basic, accessible, and sustainable microsurgical training opportunities to medical professionals from LMICs in their respective countries.

Methods: To bridge this divide, in 2020, we began procuring stereo microscopes, microsurgery training instruments, and materials from various online auction websites and other sources. All the purchases and quality checks were made by the first author, AK, and MMI members. After the quality check, we donated different microscopes and instrument setups to neurosurgeons from LMICs based on individual needs. After delivering the setup to the intended locations, we provided previously recorded training videos and organized online lectures. Additionally, we have visited some of the centers and organized in-person microanastomosis training courses in those countries.

Results: To date, we have reached out to 24 LMICs and 43 centers and donated 100 stereo microscopes and micro instrument sets. We arranged virtual meetings with those centers to introduce the equipment we provided and offer guidance on utilizing our pre-recorded training videos to initiate microsurgery practice in their institutions. In addition, we organized microsurgical training "boot camps" in thirteen locations with over 210 trainees from five countries: Turkey, Georgia, Azerbaijan, Paraguay, and Mexico.

Conclusion : Free, accessible, and sustainable microsurgical training for LMICs is feasible and MMI will further continue to contribute to microvascular laboratory training in LMICs.