No-diathermy(open) haemorrhoidectomy

the project is design to train surgical trainees, GPs and medical officers on how to perform open haemorrhoid surgery.

General surgeons will be recruited to perform this procedure on real patients and this will be on videos. 

A panel will then review these videos to come up with best practices with less complication.

This panel will break the best practice into steps which will be used to design a video module for training. 

There will be 2 video models, both virtual and real patient models.

Befor the training, a knowledge assessment test will be administered. 

After each training section, a structured objective skill assessment test, OSAT, will be administered and trainees that meet the threshold score will be awarded certification/CPD.

1. Surgeons will be given micro surgical cameras mounted to their forehead to cover live patients and record the haemorrhoid surgeries. 

2. The procedure is as below:

In this procedure, after anaesthesia, the haemorrhoid is held with a babcock.

An artery forcep is used to secure the base of the haemorrhoids whole-meal (sparing the anal sphincters).

The rectal mucosa is retracted using the artery forcep to enable an absorbable stitch to be placed up above the dentate line (for 1st haemostasis). 

A scalpel is used to remove the pile above the artery forcep.

The artery forcep is removed and the mucosa is closed with absorbable stitches (2nd haemostasis)

The anus is then packed with gauze.

3. 2 types of videos can then be made:

The live video

The live videos will be edited and the stages for doing the procedure explain.

A virtual video:

This is mainly a graphic design explaining the procedure above but not on live patients.

Open method of haemorrhoid surgery. 

Haemorrhoid is a common medical condition though the Nigerian data is lacking, but Nevertheless, haemorrhoids are common in Nigeria. The prevalence is yet to be studied but it is estimated that 50% to 85% of the world's population will be affected byhaemorrhoids at some time in their lives (Omole and Adegboye, 2012). 

The general surgeons treating this condition are few hence the need to train medical officers and GPs to perform it in LMICs. 

this procedure us designed mainly to serve rural Africa to reduce the haemorrhoid burden. 

The target is to train GPs and medical officers to be competent to reduce client load in the tertiary centres.

Haemorrhoid is a neglected tropical disease and most patient don't seek care until they have end stage disease. 

Again, most of the medical officers tend to focus on acquiring skills for abdominal surgeries, hence client with the disease often get referred creating patient load at the tertiary centres. 

This project is 2 prong. 

First, it will create awareness for medical officers, GPs, trainees to seek for and diagnose the condition. 

Secondly, it arms them with the knowledge to perform this procedure in a simple way, with good outcome using low tech/readily available equipment.

Dr Emmanuel Augustine:

clinician team leader.

Ms Kuukua Wilson: educator/graphics designer

Hero Austine: Artist/illustrator.

Medical makers c/o Dr Julielynn Wong: Technical expert.

General surgeons

IT gurus