The field of global surgery in pediatric and adolescent reconstructive urology aims to increase access to specialized surgical care in low to middle-income countries (LMICs). Augmented reality (AR) technology, especially through wearable devices, has recently introduced new possibilities for telementoring, allowing expert surgeons to guide procedures remotely. This study highlights a pilot program in global surgery education that combines in-person training with AR technology to enhance skill transfer in pediatric and reconstructive genitourinary procedures. A prospective registry was set up to track outcomes and measure skill development among local surgeons trained in these techniques.
In December 2022, the program was conducted at a tertiary referral center in the Philippines with support from the research ethics board of SickKids (REB #1000079227). Six local surgeons participated in the training, which used Vuzix M400 AR smart glasses to facilitate real-time, remote mentorship during nine procedures. These procedures included both laparoscopic techniques (orchidopexies and cystography) and open surgeries such as ileocystoplasty bladder augmentation, vesicovaginal sinus repair, penoplasty, buccal graft hypospadias repair, and redo-urethroplasty. All procedures were performed without intraoperative or immediate post-operative complications, underscoring the safety of this telementoring approach. Following the sessions, mentees showed notable improvements in their confidence and grasp of surgical skills.
This study demonstrates the feasibility of using a mixed approach of in-person and AR-based telementoring to safely conduct complex surgeries in LMICs. The promising initial results suggest that AR-supported training could significantly enhance global surgery education, especially for specialties like pediatric and reconstructive urology that require specialized skills. Continued follow-up and further research are recommended to assess the long-term impact and scalability of this collaborative model for global surgical education.
