Zoe Zimmer, MD, MPH
ZOE ZIMMER
Nominated From: University of Michigan
Research Site: Korle Bu Teaching Hospital
Research Area: Endometrial Cancer
Primary Mentor: Emma Lawrence, MD, MS
Research Project
Improving diagnosis and treatment of endometrial cancer in Ghana: Clinical evaluation of hysteroscopic and laparoscopic simulation-based training
Endometrial cancer incidence and mortality rates are rising in sub-Saharan Africa and are anticipated to double over the next twenty years. However, this malignancy is both highly detectable and survivable with prompt diagnosis and management. Minimally invasive gynecologic surgery (MIGS) techniques including hysteroscopy and laparoscopy are key tools in the identification and preferred treatment of endometrial cancer. This route of surgery uses no or small incisions for entry, thereby reducing surgical complications, shortening patient recovery times, and alleviating health system strain. However, MIGS is not commonly used in low- and middle-income countries (LMICs) as the technology and training have been variably available until recently. At the Korle Bu Teaching Hospital in Ghana, the largest teaching and referral hospital in the country, prior research discovered that, though the equipment and patient need are present, gaps in surgeon comfort and training were the main reasons MIGS was not offered. This project first aims to refine a currently developed hysteroscopy and laparoscopy simulation-based curricula through a multi-national expert Delphi panel. Second, it will implement and evaluate the impact of hysteroscopy and laparoscopy simulated-based curricula on clinician knowledge, skill, and confidence in MIGS through pre- and post-assessment. Third it will evaluate the rates of surgical route selection after program implementation and elicit Ghanaian surgeon attitudes related to MIGS. Ultimately, the project’s objective is to determine how best to promote MIGS techniques to diagnose and manage endometrial cancer to limit the associated increasing morbidity and mortality in sub-Saharan Africa.
Research Significance
Endometrial cancer is increasing in prevalence in sub-Saharan Africa, but is highly treatable if diagnosed and treated early. Minimally invasive gynecologic surgery techniques are imperative to the early discovery and treatment of this malignancy. Previous evaluations at Korle Bu Teaching Hospital in Accra, Ghana have demonstrated that an absence of training hinders the use of minimally invasive gynecologic surgery. This project aims to build a hysteroscopic and laparoscopic simulation-based training curriculum in order to building capacity for minimally invasive gynecologic surgery at this site, which may be replicated in similar low- and middle-income country settings.
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