Nine out of ten people in low- and middle-income countries lack access to safe surgical care, according to The Lancet, and that unmet need has grown during the last decade. Training more surgeons is therefore an urgent priority. But traditional “over-the-shoulder” teaching in crowded operating rooms is constrained by infection-control protocols and other limitations – a challenge that is far from unique to low-resource settings.
An innovative solution developed and refined across Uganda, Kenya and Ethiopia is now being evaluated at the National Burn Centre, Uppsala University Hospital, Sweden. It uses RealWear head-mounted cameras combined with Vidhance for Surgery software to enable video-based surgical training that overcomes these bottlenecks. A paper published in the European Burn Journal describes the experience from the field and what’s next.
Surgery training: learnings from East Africa
Over four years, a team led by researchers at the National Burn Centre, Uppsala University Hospital, together with 2nd Chance Association – a Swiss non-profit dedicated to developing surgical capacity in low-resource settings – used the system in reconstructive-surgery workshops across Uganda, Kenya and Ethiopia. The surgeon or nurse wears the camera device during the procedure while trainees gather in an adjacent room, observing a stabilized, high-definition feed from the wearer’s perspective with full two-way audio. The system is voice-controlled and hands-free, allowing the wearer to regulate incoming audio and control what visual content is shared – without interrupting the sterile field or surgical workflow. Setup takes minutes.
Preliminary feedback from surgeons and anaesthesiologists across eight African countries showed a high level of acceptance. More than half of participants felt very actively involved while observing remotely, one third felt much involved, and only one tenth remained neutral. Participants highlighted better learning outcomes, clearer visualization of procedures, and improved patient safety through fewer people in the procedure room. The system performed consistently in settings where robustness and ease of use are not optional – and those same qualities turn out to matter just as much in high-income hospitals.
Burn care training: a pilot study in Sweden
Burn care is unusually dependent on visual assessment – distinguishing wound depth, graft viability and infection status is a skill that develops through repeated, supervised exposure. Yet infection-control protocols are particularly stringent in this field, where dressing changes, hydrotherapy and grafting all involve open wounds. Research has shown that frequent door openings during surgery independently increase the risk of surgical site infection, which means every additional person in the room carries a real cost. As a result, trainees observe from poor angles, queue for access, or receive verbal descriptions of what they cannot see.
The pilot at Uppsala University Hospital tests whether the head-mounted camera system can resolve these limitations. Preliminary feedback is encouraging. The device is lightweight and does not interfere with personal protective equipment, operates on a local network without dependence on hospital Wi-Fi, and delivers immediate two-way audio between the wearer and the observation room. Image quality is noted as stable and colour-accurate even under strong operating-room lights – a technically demanding condition that matters for diagnostic utility. Quantitative results are forthcoming, but the qualitative response is described by the authors as strongly positive.
Reverse innovation: constraint as a design advantage
The authors frame their findings through the concept of reverse innovation – the transfer of solutions developed in low-resource settings to high-income environments, rather than the opposite. Technologies refined in East African operating theatres carry design decisions tested against real clinical workflows under genuine pressure, and those decisions – around weight, voice control, local network architecture and sterile field compatibility – turn out to address the same barriers that have prevented adoption in advanced hospitals.
Although highly digitalized university hospitals in Sweden have access to sophisticated video infrastructure, head-mounted training systems have not yet been adopted. The explanation is that most available cameras were designed for laparoscopic or microscope-based procedures, not around the educational and ergonomic realities of surgical teams. That is the gap this system was built to fill.
Beyond real-time observation
The paper also identifies two further applications: archived footage for independent procedure review, and remote supervision that allows consultants to guide trainees without being physically present. Both point toward the same underlying question – if the educational bottleneck in surgical training is structural, what would it mean to treat wearable video infrastructure as a core component of how surgical competence is built and maintained?
The authors put it simply: “As global surgery advances toward greater equity, tools that allow clinicians to see through each other’s eyes may prove indispensable.”
Full reference: Snorrason EL, Huss F, Modarressi A, Kildal M. From Low-Resource Innovation to High-Resource Learning: Head-Mounted Cameras as a Tool to Strengthen Surgical and Burn Care Training. Eur. Burn J. 2026, 7(2), 20. doi.org/10.3390/ebj7020020 – Open access, CC BY. Read Study →
The Vidhance for Surgery software referenced in this study is developed by Vidhance AB, Uppsala, Sweden. Vidhance for Surgery Software →
Interested in evaluating the system for your department? Vidhance for Surgery Starter Kit →
