Closing the Gap: Evaluating Skull Base and Ventricular Endoscopy Across Latin American and African Countries

Background: Neurosurgical capabilities exhibit significant disparities across Latin American and African countries. While advanced institutions possess state-of-the-art technology, many underdeveloped centers struggle with basic procedures. This study assesses the current state of endoscopic neurosurgery in Latin American and Portuguese or Spanish-speaking African countries (LAPSSAC) and explores the infrastructure and training needs.

Methods: A comprehensive 50-question questionnaire was distributed to neurosurgeons across 19 Latin American countries and six Portuguese- or Spanish-speaking African countries. The survey, conducted from May 19 to June 20, 2023, collected data on institutional types, residency programs, availability of endoscopic equipment, types of procedures performed, and interest in additional training. Quantitative statistical analysis was performed.

Results: The study received 202 responses from 216 hospitals in 22 countries. Most respondents worked in public institutions (69.42%), with many centers having residency programs (58.42%). Essential equipment for endoscopic procedures was available in 83.17% of hospitals, with 71.29% equipped for ventricular and 61.39% for skull base endoscopy. Ventricular endoscopy was performed in 89.11% of hospitals, while skull base procedures were performed in 71.78%. A significant gap in equipment and training was identified, particularly in African countries. Interest in additional training was high, with 83.33 and 92.41% of respondents expressing interest in ventricular and skull base endoscopy training, respectively.

Conclusion: While many centers possess basic tools for endoscopic procedures, significant gaps remain in equipment and training. Enhanced international collaborations and targeted investments in education and infrastructure are crucial to address these disparities and improve neurosurgical care in low-and-middle-income countries. With the data from this study, there is a clear opportunity to connect developed centers in LAPSSAC with young neurosurgeons seeking complementary training. This collaboration can significantly enhance surgical care in these regions by creating an efficient, cost-effective learning network with minimal language barriers. The involvement of neurosurgical entities such as the World Federation of Neurosurgery (WFNS) and the Latin American Federation of Neurosurgical Societies (FLANC) is essential to the success of this initiative, ensuring that disparities in neurosurgical care are addressed and high-quality training and resources are provided to those who need it most. Together, we can forge a future where equitable access to neurosurgical care is a reality for all, transforming lives and communities across the globe.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025