Laparoscopic Surgery in a Nigerian Teaching Hospital for 1 Year: Challenges and Effect on Outcomes

Abstract

BACKGROUND: Laparoscopic surgery has developed rapidly in developed nations within a relatively short time to become a major method of treating surgical diseases, with increasing application across specialties. However this is not the situation in developing countries like Nigeria. This may be as a result of local challenges to the performance of laparoscopic procedures. It is important to identify what these challenges are.
METHODOLOGY: We prospectively studied problems encountered during the performance of laparoscopic procedures, and their effects on the procedure in a Nigerian teaching hospital for a year. Demographic information, laparoscopic procedure, problems encountered and effect on procedure, and outcomes were analyzed using descriptive statistics.
RESULTS: Our sample consisted of 21 patients who had laparoscopic procedures performed by the authors; 12 (57%) were therapeutic procedures. Average age was 34.1 years (range 18-50 years) and majority (61.9%) were female. Problems encountered included non functioning/malfunctioning equipment (76.2%), power outages (33.3%), and dead light source bulbs (14.3%).  There were 5 (23.8%)  conversions to open surgery as a result of problems encountered; another conversion (4.8%) was to tackle an ascending colon tumour discovered at laparoscopy.
CONCLUSION: The performance of laparoscopic procedures in a Nigerian public hospital is affected largely by inadequate and often malfunctioning equipment, and attention to these may reduce rates of conversion to open surgery.

KEY WORDS:  Laparoscopic procedures,