Report of the First Completed On-site Vascular Neurosurgery Fellowship Program in Cameroon

Background and Aim: Vascular neurosurgical expertise is highly on demand in African countries. To create a sustainable environment for treating the patients, local neurosurgeons have to be trained and be able to operate under the local circumstances and given equipment. On-site fellowship programs are needed. We report on the results of the first completed on-site cerebrovascular fellowship in Cameroon and to our knowledge in central Africa. Methods and Materials/Patients: ۴۲ cerebrovascular cases (۳۸ aneurysms) were operated by the cerebrovascular expert and his fellows microsurgically from April ۲۰۲۱ to November ۲۰۲۲. The expert traveled to Cameroon ۴ times. Online conferences and theoretical courses were organized. Results: The overall morbidity rate was ۱۰.۵% with a long-term functional morbidity rate of ۵.۲%. Intraoperative mortality rate was ۰%- and ۳۰-days mortality rate ۲.۷%. After completion of the program the fellow´s surgical skills concerning operating time, intraoperative complications and mortality improved significantly. Conclusion: The on-site cerebrovascular fellowship program in sub-saharan countries is feasible and provides to the patient’s high-quality surgery with outcomes similar to western countries. The case load in ۲ years is sufficient enough to provide an excellent training to the local fellows. There is a high demand on further fellowships like the one we describe. It is important for the trainer to stay dedicated to the program until the completion of it. To provide the fellows with a high case load, only two fellows should be trained which are participating in every case.

Keywords:

Vascular neurosurgery fellowship , Sub-Saharan Africa , brain aneurysm , microneurosurgical clipping