A Retrospective Study of Laparoscopic Surgery Cases at LASUTH 2011-2015

Abstract

BACKGROUND
The Lagos State University Teaching Hospital (LASUTH) commenced Laparoscopic Surgery in March 2011 following 3 missions (in March, May and July
2011) involving Overseas Facilitators from the USA and the UK with support from the Hospital Management and Non-Governmental Organizations.
Since the time of commencement, laparoscopic surgery has become a welcome option for basic procedures including cholecystectomy and some
appendectomies. To ascertain the impact and performance of this new modality in our setting we undertook the step to audit Laparoscopic Surgeries in
LASUTH from 2011 to 2015.
METHODOLOGY:
A retrospective study of all Laparoscopic Surgeries performed in the General Surgery Unit between 2011 and 2015 was carried out through data
collection from the Operation register and a specially designed Excel spreadsheet including age, sex, indications, conversions, complications, blood loss
and length of post-operative stay were entered into SPSS version 19 for statistical analysis of common frequencies.
RESULTS:
A total of 40 patients had laparoscopic procedures representing 2% of a total of 2,000 open general surgery procedures in the period under review.
There were 12 males (30%) and 28 females (70%) with age range from 5 – 75years (mean age of 38.8years). The chief complaints were right
hypochondrial pain in 15 patients (37.5%) and right iliac fossa pain in 14 patients (35%). Laparoscopic cholecystectomy was successfully performed in 13
patients (32.5%), Laparoscopic appendectomy also in 13 patients (32.5%), Diagnostic Laparoscopy in 9 patients (17.5%). Others are laparoscopic
hernioplasty-1 patient (2.5%), laparoscopic fundoplication-1 patient (2.5%). There were 3 conversions to open surgery representing a conversion rate
of 7.5%. The procedure was uneventful in 33 patients (82.5%) whilst complications ranged from post-operativenausea and/or vomiting in 2 patients
(5%), sickle cell bone pain in 2 patients (5%), and 1 patient (2.5%) each with urinary retention, biloma, and bile duct injury. A total of 22 patients (55% of
the cases) were discharged within 2 days post-surgery whilst the longest duration of 21 days post operatively followed open cholecystectomy after
conversion.
CONCLUSION:
Laparoscopic Surgery at LASUTH is making gradual progress notwithstanding well-known limitations in such newly established procedures in a
developing country such as Nigeria. The long term promise and prospects remains great.