The Surgeons Working In Africa Together For Safer Surgery (SWIFTSS) Hernia Model: Putting Ultra-low-cost Hernia Simulation Into Everybody’s Hands

The Surgeons Working In Africa Together For Safer Surgery (SWIFTSS) Hernia Model: Putting Ultra-low-cost Hernia Simulation Into Everybody’s Hands

Mohammad Rahman , Anthony Abbot Kamara, Mark Szymankiewicz, Lesley Hunt
Sheffield Teaching Hospitals NHS Foundation Trust,, Sheffield, United Kingdom; Partners in Health, Koidu Government Hospital, Koidu, Sierra Leone; Salisbury NHS Foundation Trust andUniversity of Winchester Centre for Global Health, Salisbury and Winchester, United Kingdom; Sheffield Teaching Hospitals NHS Foundation Trust and SWIFTSS, Sheffield, United Kingdom

Introduction: The SWIFTSS Affordable Mesh Hernia Surgery Initiative empowers African teams to prepare and use hernia mesh. Existing low-cost hernia simulation models are retained behind pay-walls, commercially sold or use 3-D printing beyond reach of Low Income Country (LIC) trainers. Online how-to videos receive > 500 million views daily.

Aim: Design a mesh hernia training model, only using materials readily available in LICs, with free online how-to make video.

Method: Model uses tailor’s materials, cardboard and glue and provides high-fidelity inguinal anatomy for the nuances of mesh insertion. Step-by-step how-to make video and downloadable pattern. User involvement throughout innovation process. Test purchases in LIC.

Results: Dec 2023 to Mar 2024 surgeon and trainee testers in Tanzania, Sierra Leone (SL), Ghana and UK identified deficiencies in prototype e.g. problematic pubic tubercle palpation, ilioinguinal nerve easily overlooked. Problems addressed Mar to August 2024. SWIFTSS model shares the limitations of all ultra-low-cost models (no bleeding and limited sac dissection).

Test purchase: all materials available Koidu (provincial city in SL). SL ranks 178th on the Human Development Index.

2024 per model cost: Leones 75 (£2.50). Bulk purchase and omission of simulated leather cover (for subcuticular simulation) reduced unit cost to £0.75 (US $1).

How-to make it video with printable pattern templates developed.

Available at https://swiftss.org from end Aug 2025. Free viewing, downloading and sharing.

Conclusion: Rapid upscaling of LIC surgery requires increased local training capacity, removing dependence on expatriate trainers. A method of producing acceptable training models directly in LICs is described.

Keywords: Safer Surgery, Training Model, Mesh Hernia Repair