The Global Laparoscopic Advancement Pro Program (GLAP Pro) is an international collaborative educational initiative aimed at enhancing surgeons’ laparoscopic skills and knowledge. It focuses on teaching basic laparoscopic techniques and validating surgeons’ proficiency through the Fundamentals of Laparoscopic Surgery (FLS) certification. The ultimate objective is to improve the safety and quality of care for patients undergoing laparoscopic surgery.
Why GLAP Pro?
Access to safe and affordable surgery is not possible for over 5 billion people worldwide. Low- and middle-income countries (LMICs) represent 48% of the global population but have only 19% of surgeons.1 Furthermore, despite the well-studied benefits of the minimally invasive approach, laparoscopic surgery is still not an option for majority of the LMIC population due to lack of equipment and available laparoscopic surgeons. Training surgeons in the most essential laparoscopic procedures will increase the availability of minimally invasive surgical care, improving patients’ recovery and minimizing postoperative complications. However, many LMIC countries lack a formal educational curriculum or certification for laparoscopic skills.
To address this need for a laparoscopic surgery curriculum taught by expert surgeons, the Global Affairs Committee of Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has created the Global Laparoscopic Advancement Program (GLAP) which offers laparoscopic training in LMICs. Over the last 7 years, GLAP has trained hundreds of surgeons and surgical residents around the world, including Mexico, Costa Rica, Namibia, and Ethiopia. SAGES Go Global has now enhanced the standard GLAP program to GLAP Pro, with an added emphasis on FLS certification as the measure for laparoscopic proficiency. This new program will include 4-6 months of intensive FLS knowledge and skills preparation with expert GLAP faculty via a virtual platform. This is followed by a 5-day onsite GLAP course, cumulating with FLS certification. The main focus of the new GLAP Pro program is on in-depth coaching of the FLS educational modules and moderating technical FLS skills practice.
GLAP Pro Program:
The components of the GLAP Pro program include:
- Intensive virtual FLS preparatory course: The curriculum will begin with a 4-6 month virtual Educational Curriculum, with both self-directed and proctored components, focusing on didactic modules and FLS skills practice using simulation box trainers. This curriculum will 3 parts:
- PART 1: The standard FLS modules from SAGES FLS website
- PART 2: Supplemental curriculum to FLS modules, with in-depth review of each topic and context-relevant information for surgeons from low-resource regions.
- PART 3: Additional procedure-specific modules, including common laparoscopic general surgery, gynecological, and urological procedures.
This preparatory program will be administered through a collaboration of SAGES faculty and expert local faculty. The objective of this course is to teach FLS modules in depth, to allow participants to practice answering multiple-choice questions similar to those present on the FLS written test, and to perfect the technical skills needed to pass the FLS skills test. Pre-recorded didactic lectures covering each FLS educational module will be available. In addition, there will be multiple-choice practice questions with answer explanations within each module, and participants are expected to complete an assessment prior to advancing to the next level. Participants will also be taught how to make their own low-cost simulator box and skills materials, ensuring adequate practice the 5 FLS manual skills at home prior to the on-site course.
- In-person GLAP course: This is a 5-day on-site course delivered through didactic lectures, hands-on laparoscopic skills practice using simulation box trainers, and live operating room proctoring (when available). The didactic content covers concepts of simulation-based education, objective assessment of skills, basics of performing laparoscopic surgery, FLS, Fundamentals of Surgical Energy (FUSE), and perioperative considerations unique to laparoscopic surgery. The hands-on component includes informal pre- and post-program FLS testing, as well as one-on-one education and deliberate practice of FLS and other simulation-based tasks throughout the week. The culmination of the course involves live OR proctoring of laparoscopic cases, where SAGES faculty provide immediate feedback of participants’ laparoscopic operative skills in their local environment.
- On-going deliberate laparoscopic skills practice and mentorship with SAGES faculty: Each participant will be paired with a SAGES faculty mentor for the duration of the program. Participants are expected to achieve 20 hours of self-directed FLS practice in simulation boxes over the 4-6 month period. Each month, participants will attend a virtual meeting where s/he will show one video of their performance on the five FLS tasks to their mentor for feedback on their progressive acquisition of skills.
- FLS Certification: At the completion of the GLAP Pro Program, participants will have the opportunity to take the FLS test remotely.
Access GLAP Pro Online Curriculum