LAUSR

OBJECTIVE We aim to provide a thorough description of the efforts and outcomes of the "Co-Pilot Project" in Ukraine which facilitates neurosurgical collaboration between American and Ukrainian physicians. METHODS The "Co-Pilot Project," which operates under its parent non-profit organization, Razom, organized multiple trips for American physicians to Ukraine. Activities included consulting in clinic, assisting with neurosurgical operations, and providing didactic lectures. Further efforts have included coordinating training opportunities for Ukrainian surgeons. We retrospectively reviewed all operations performed by Ukrainian "partner" physicians alongside American "co-pilot" physicians across Ukraine since August 2016. RESULTS Teams of Ukrainian and American physicians operated on 78 patients (24 children and 54 adults) for a total of 84 procedures in five different cities (Kyiv, Lutsk, Lviv, Odesa, and Stryi) of Ukraine. Operations were classified into the following categories: adult brain tumors (39), adult spine tumors (1), epilepsy (9), pain (2), pediatric brain tumors (11), vascular/endovascular (10), and miscellaneous (12). Four illustrative cases are described in detail. Of the patients with brain tumors, 43.5% (20/46) had giant tumors and gross total resection (GTR) or near total resection (NTR) was achieved in 78.3% (36/46). CONCLUSIONS Profound disparities in neurosurgical care exist globally which has led to the formation of collaborative relationships between physicians from various countries. We hope that the work of the "Co-Pilot Project" in Ukraine can serve as a template for effective international neurosurgical collaboration in other low-to-middle-income countries (LMICs).