Laparoscopic Appendectomy in a Developing African Country

Abstract

Background: The wide spread introduction of laparoscopic surgery to  surgical practice in Nigeria is a relatively new development. The benefits of laparoscopic appendicectomy are controversial. Laparoscopic  appendicectomy (LA) has always generated controversy due to its cost and time consuming nature and the multiple trocar points required which  arguably approximates to the length of the incision in open  appendicectomy. The purpose of this study is to describe the unit experience in a developing country.
Method: This is a retrospective study conducted by the laparoscopic  surgery unit of the department of surgery. The study includes all patients who consented to laparoscopic appendicectomy over a period of eighteen months.
Results: Thirty patients out of a hundred consented to laparoscopic appendicectomy with a male female ratio of 1:1.5.The mean operating time was 62 minutes. The duration of postoperative admission ranged from 1 to 7 days with a mean of 2.2days.There was 1(3.3%) conversion and 1(3.3%) pelvic collection. There was no readmission over three  months of follow up.
Conclusion: Laparoscopic appendicectomy is safe and allows early  discharge. The low incidence of cholecystectomy in Nigeria compared with the high incidence of appendicitis in Nigeria supports the adoption of  surgery for a different disease entity apart from cholecystectomy for  training (hand and eye coordination). The level of safety demonstrated in the initial cases of laparoscopic appendicectomy supports adopting LA as a procedure of choice in acquisition of basic laparoscopic surgery skills.