{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:00:33Z","timestamp":1791554433052,"version":"4.3.4"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T00:00:00Z","timestamp":1445212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T00:00:00Z","timestamp":1445212800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Papua New Guinea (PNG) is a developing Pacific Nation of 7.3\u00a0million people. Although neurosurgery training was introduced to PNG in the year 2000, it was in 2003 that a neurosurgery service was established. Prior to this time, neurosurgery in PNG was performed by general surgeons, with some assistance from visiting Australian neurosurgeons. Neurosurgical training was introduced to PNG in 2000. The model involved a further 3 years of training for a surgeon who had already completed 4 years of general surgical training. We aim to review the output, outcomes and impact achieved by training the first national neurosurgeon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data on activity (output) and outcomes were collected prospectively from 2003\u20132012. Ongoing mentoring and continuing professional development were provided through annual neurosurgical visits from Australia. There were serious limitations in the provision of equipment, with a lack of computerized tomographic or MR imaging, and adjuvant oncological services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 1618\u00a0neurosurgery admissions, 1020\u00a0neurosurgical procedures with a 5.74 % overall mortality. Seventy percent of cases presented as emergencies. There were improved outcomes, particularly for head injuries, whilst hydrocephalus was managed with an acceptable morbidity and revision rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The training of a neurosurgeon resulted in PNG patients receiving a better range of surgical services, with a lower mortality. The outcomes able to be delivered were limited by late presentations of patients and lack of resources including imaging. These themes are familiar to all low\u2010 and middle\u2010income countries (LMICs) and this may serve as a model for other LMIC neurosurgical services to adopt as they consider whether to establish and develop neurosurgical and other sub\u2010specialist surgical services.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-015-3268-1","type":"journal-article","created":{"date-parts":[[2015,10,19]],"date-time":"2015-10-19T18:55:42Z","timestamp":1445280942000},"page":"251-257","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Establishment and Development of Neurosurgery Services in Papua New Guinea"],"prefix":"10.1002","volume":"40","author":[{"given":"W. Matui","family":"Kaptigau","sequence":"first","affiliation":[{"name":"Department of Surgery Port Moresby General Hospital Port Moresby Papua New Guinea"},{"name":"Department of Surgery University of Papua New Guinea Port Moresby Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey V.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Surgery Port Moresby General Hospital Port Moresby Papua New Guinea"},{"name":"Department of Surgery University of Papua New Guinea Port Moresby Papua New Guinea"},{"name":"Department of Neurosurgery Alfred Hospital Melbourne VIC Australia"},{"name":"Department of Surgery. Central Clinical School Monash University 6th Floor, The Alfred Centre, 99 Commercial Road 3004 Melbourne VIC Australia"},{"name":"F. Edward H\u00e9bert School of Medicine Uniformed Services University of the Health Sciences Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikau","family":"Kevau","sequence":"additional","affiliation":[{"name":"Department of Surgery Port Moresby General Hospital Port Moresby Papua New Guinea"},{"name":"Department of Surgery University of Papua New Guinea Port Moresby Papua New Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Watters","sequence":"additional","affiliation":[{"name":"Department of Surgery Port Moresby General Hospital Port Moresby Papua New Guinea"},{"name":"Department of Surgery University of Papua New Guinea Port Moresby Papua New Guinea"},{"name":"School of Medicine and Health Sciences Deakin University Geelong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,10,19]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"463","volume-title":"United Nations World Population Prospects: The 2012 Revision, vol I: Comprehensive Tables","author":"United Nations","year":"2013"},{"key":"e_1_2_7_3_2","unstructured":"World Bank(2013)Papua New Guinea.http:\/\/data.worldbank.org\/country\/papua\u2010new\u2010guinea. 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