1038 Microsurgery Without Borders: No-Cost, Hands-On Basic Microvascular Anastomosis Slingshot Program for LMICs

INTRODUCTION: Since the 1960s, despite advances in microsurgical techniques, low- and middle-income countries (LMICs) continue to experience a critical shortfall of five million essential neurosurgical procedures annually. The scarcity of local training compels neurosurgeons to pursue costly, time-intensive education abroad. METHODS: Launched in 2020, the Madison Microneurosurgery Initiative (MMI) has redefined access to microsurgical education by deploying fully-equipped mobile training units to LMICs' hospitals. Each unit includes 10 high-definition stereo microscopes, a demonstration microscope with dual observer tubes, and a comprehensive array of surgical instruments and materials. Our team collaborates closely with local medical professionals to provide immersive, free training sessions. RESULTS: MMI has successfully established 13 training hubs across five countries: TÜrkiye, Georgia, Azerbaijan, Paraguay, and Mexico, often introducing such training for the first time in these regions. Our courses range from one-day workshops to three-day comprehensive programs, designed to meet the specific needs and capacities of each host country. Thus far, 210 healthcare professionals have been trained in microvascular anastomosis through hands-on experience, enhanced by theoretical lectures and live demonstrations. Our training modules cover Penrose drain anastomosis with fine sutures (6-0/7-0), advanced silicone tube anastomosis with ultra-fine sutures (9-0), and detailed chicken vessel and live rat surgery anastomosis using micro sutures (10-0). To ensure ongoing training, we donate our microsurgical setups to the participating hospitals and provide access to our extensive digital training library. CONCLUSIONS: The Madison Microneurosurgery Initiative demonstrates that no-cost, accessible microsurgical training is not only feasible but also transformative for global health. By equipping LMICs with advanced surgical skills and knowledge, MMI is setting new standards in educational equity and empowerment.