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'Allan in Canada! Can you hear us?"

The voice crackles out of the computer speaker, filling the small office in Toronto Western Hospital where Allan Okrainec, a 31-year-old general surgeon, bends over his laptop.

"I'm here, Alemayehu," Dr. Okrainec says loudly into a small headset. "Can you hear me?"

This has been Dr. Okrainec's Tuesday routine for the past six weeks: First, establish a reliable Internet connection between two doctors' offices in Toronto and Botswana.

Then, teach a small group of eager Botswana-based surgeons the basics of a minimally invasive surgical technique that is increasingly common in Western nations due to its health benefits - but rarely used in Africa.

Laparoscopic surgery, also known as "keyhole surgery," involves inserting a microscopic camera and ultra-slim instruments into the patient through tiny incisions, avoiding the large cuts associated with traditional open surgeries.

With most of a surgeon's work broadcast on an operating room television screen anyway, laparoscopic surgery is surprisingly well-suited to the Internet.

To teach his course, Dr. Okrainec demonstrates skills, such as cutting and suturing, on a simulation device. In Gaborone, Botswana's capital city, the surgeons practice their skills while Dr. Okrainec looks on.

A projection screen shows both sides what's happening in real time, and questions and instructions are exchanged through headsets.

The only equipment required in both countries is a laptop, a television screen and a web cam.

"That's what's really unique about this," says Dr. Okrainec. "It costs them really nothing."

This experiment in medical instruction is designed to teach other doctors skills they may not be able to learn in Botswana due to a lack of equipment, funding and

training.

If it's successful, the two Canadians who designed the program - Dr. Okrainec and Georges Azzie, a pediatric surgeon at Toronto's Hospital for Sick Children - hope it can help train doctors in developing nations around the world.

Benefits of laparoscopic surgeries include less cutting, faster recovery times and lower risk of transmission of diseases such as AIDS, which affects almost a quarter of the 1.7 million people living in Botswana.

However, it's rarely used in Africa because of a lack of funds for equipment, and lack of training. Some doctors leave Botswana to receive training in developed countries, and end up leaving Africa for good.

The idea came to Dr. Azzie and Dr. Okrainec last March when they travelled to Gaborone to teach laparoscopic surgery to local surgeons.

Dr. Okrainec, whose research interests lie in medical education, wondered if there was a way to continue teaching the doctors in their home country once the Canadian team had left Botswana.

A self-described "techno-geek," he experimented with Internet and simulator setups in his house. He realized that if images could be transmitted live between his living room and kitchen, why not between Toronto and Gaborone?

On this particular Tuesday, there are five surgeons receiving Dr. Okrainec's instruction in a small office in Gaborone. They wear shorts and sleeveless shirts to beat the 36-degree heat. They sit in a satellite office located one kilometre from their offices in Princes Marina Hospital, because it has a more reliable Internet connection.

"You're holding the needles here; I don't love that because you're going to poke things," Dr. Okrainec says, watching the projection screen as Felix Tshilombo, a general surgeon trained in the Congo, practises tying a suture.

The surgeons based in Botswana have been trained in many different countries, and all are skilled surgeons in areas including urology and gynecology. They know how to do traditional surgeries, but are excited to advance into the laparoscopic arena.

"I think we'll improve a lot and then we will apply it later," said Leguin Huang, a urologist trained in China.

Dr. Okrainec and Dr. Azzie will return to Botswana next month, where they will assess the skills of their trainees according to an internationally recognized training course called Fundamentals of Laparoscopic Surgery.

When they first visited in March, only two of the 20 Africa-based doctors passed the test, after two days of instruction.

But after two months of long-distance education, both sides are confident that the pass rate will be much higher in October.

"From the first day we've improved a lot," said Alemayehu Bedada, a general surgeon trained in Ethiopia.