Local Adaptations Aids Establishment of Laparoscopic Surgery in a Semi-urban Nigerian Hospital

Adewale O Adisa, MBChB FWACS FMCSNig DMAS, Oladejo O Lawal, MBBS FMCSNig FWACS, Olukayode A Arowolo, MBBS FWACS, Olusegun I Alatise, MBChB FWACS. Obafemi Awolowo University, Ile-Ife, Nigeria

 

 Introduction: After several years of lagging behind due to several constraints, many general surgeons across Nigeria are now performing laparoscopic surgery. Many are however still concerned about its feasibility and safety in view of several local adaptations employed.
Methods and procedure: All patients with general surgical conditions who had laparoscopic surgery from January 2009 through June 2011 in our hospital were prospectively studied. A modified laparoscopic set-up employing locally assembled and a few imported materials were employed for the procedures. Members of the operation team were trained locally to facilitate their familiarization with laparoscopic surgery.
Results: One hundred and fifty-five patients whose ages ranged between 18 and 72 years had laparoscopic surgeries within the study period. These include 38(24.5%) laparoscopic cholecystectomies, 31(20.0%) appendectomies, 48(30.9%) diagnostic laparoscopy for staging and biopsy of intra-abdominal masses, 18(11.6%) laparoscopic adhesiolyses, 2(1.3%) colorectal surgeries, 5(3.2%) laparoscopic hernia repairs and 13(8.4%) other varied procedures. All diagnostic procedures were performed as day cases while the duration of hospital stay was 1-3 days for the therapeutic procedures. The commonest complication was superficial port site infection in 11(7.1%) patient. No mortality was recorded. Various local adaptation techniques were introduced to facilitate the establishment and sustenance of the procure in our setting leading to a rapid acceptance of the procedure among our patients and co-workers.
Conclusion: Our outcome shows the feasibility of laparoscopic surgery in Nigeria. We advocate similar local adaptations to increase the use of laparoscopic surgery in hospitals located in limited resource settings.
Key words: Local adaptations, laparoscopic surgery, Nigeria.


Session Number: Panel – SAGES Heroes
Program Number: S024

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