title: Targeted neurosurgical outreach: 5-year follow-up of operative skill transfer and sustainable care in Lima, Peru.
abstract: OBJECTIVE
  This study evaluates the efficacy of operative skill transfer in the context of targeted pediatric outreach missions. In addition, the ability to implement surgical care improvements that are sustainable is investigated.
  
  
  METHODS
  Three 1-week targeted neurosurgical missions were performed (2004-2006) to teach neuroendoscopy, which included donation of the necessary equipment so newly acquired surgical skills could be performed by local neurosurgeons in between and after the departure of the mission team. After the targeted missions were completed, 5 years of neuroendoscopy case follow-up data were obtained.
  
  
  RESULTS
  After performing pediatric neurosurgery missions in 2004-2006, with a focus on teaching neuroendoscopy, the host team demonstrated the sustainability of our didactic efforts in the subsequent 5 years by performing cases independently for their citizens. To date, a total of 196 operations have been performed in the past 5 years independent of any visiting team.
  
  
  CONCLUSIONS
  Effective operative skill transfer to host neurosurgeons can be accomplished with limited international team visits utilizing a targeted approach that minimizes expenditures on personnel and capital. With the priority being teaching of an operative technique, as opposed to perennially performing operations by the mission team, sustainable surgical care was achieved after missions officially concluded.
authors.affiliation: Division of Neurosurgery, MOB 2001, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010, USA.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Duenas
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Hahn
authors.forename: Henry E
authors.initials: HE
authors.lastname: Aryan
authors.forename: Michael V
authors.initials: MV
authors.lastname: Levy
authors.forename: Rahul
authors.initials: R
authors.lastname: Jandial
mesh_terms: D003695:Delivery of Health Care; D003906:Developing Countries; D006801:Humans; D008493:Medical Missions; D009493:Neurosurgery / Q000193:education*; D010568:Peru