Mapping neuroendoscopy practices: an assessment of endoscopic practices and training needs across Latin American and African countries.

Abstract

Neurosurgical capabilities vary significantly across Latin American and African countries, with advanced centers having state-of-the-art technology while others struggle with basic procedures. This study aims to assess the current state of endoscopic neurosurgery in Latin American and Portuguese or Spanish-speaking African countries (LAPSSAC), focusing on infrastructure and training needs. A 50-question survey was distributed to neurosurgeons across 19 Latin American countries and six Portuguese- or Spanish-speaking African countries between May 19th and June 20th, 2023. The survey covered institutional types, residency programs, availability of endoscopic equipment, types of procedures performed, and interest in additional training. Data from 202 responses representing 216 hospitals were analyzed using descriptive statistics. Most respondents worked in public institutions (69.42%), with 58.42% having residency programs. Essential equipment for endoscopic procedures was available in 83.17% of hospitals, while 71.29% had the necessary tools for ventricular and 61.39% for skull base endoscopy. Ventricular endoscopy was performed in 89.11% of hospitals, compared to 71.78% for skull base procedures. Significant gaps in equipment and training were identified, especially in African countries. Interest in additional training was high, with 83.33% and 92.41% of respondents expressing a need for training in ventricular and skull base endoscopy, respectively. The findings highlight disparities in neurosurgical capabilities, with many centers lacking essential resources for endoscopic procedures. While most hospitals have some basic tools, there remains a need for investment in education and equipment. The study suggests that enhancing international collaborations and targeted investments could address these gaps and improve neurosurgical care in low-resource settings. Significant disparities in neuroendoscopic training and equipment exist across LAPSSAC. Addressing these disparities through strategic investments and international partnerships is essential to improving neurosurgical outcomes in these regions.