Abstract
Delivering surgical services in low- and middle-income countries often requires adaptability and ingenuity due to resource limitations. This case report describes how a visiting surgical team in a Pacific Island nation overcame the absence of a diathermy foot pedal during a transurethral resection of the prostate by collaborating with both on-site and remote biomedical engineers. The team modified a handheld pencil diathermy to mimic foot pedal functionality. The procedure was successfully completed without complications. This case highlights the challenges faced by visiting teams in low- and middle-income countries and the importance of collaboration and innovation in overcoming equipment shortages.