Local Adaptations Aid Establishment Of

Laparoscopic Surgery In A Semi-urban Nigerian Hospital

AO Adisa, OO Lawal, OA Arowolo, OI Alatise.

Adisa Adewale MBChB, FWACS, FMCS(Nig.), D.MAS

Department of Surgery,Obafemi Awolowo University, &

Obafemi Awolowo University Teaching Hospitals ComplexIle-Ife 220005, Nigeria

E mail: wadisc@yahoo.com

SAGES 2012 San Diego, CA

SAGES 2012 Disclosure Slide

AO Adisa OO Lawal

OA Arowolo OI Alatise

Nothing To Disclose

Laparoscopic Surgery in Nigeria

Decades of diagnostic procedures

Gynecological procedures

Visiting Surgeons

Few private centers, occasional practices

OAUTHC

Ile-Ife, South-West Nigeria. Semi-urban, largely agrarian

population. Laparoscopy in general surgery

Initial attempt in 2008 Consistent deployment from 2009 Improvised set-up Local adaptations

1 2

34

OAUTHC, Ile-Ife

Local Adaptations & Improvisations

Locally assembled set-up Easily maintained and reproducible

Re-useable hand instruments Improvisations for consumables

Camera cover Endoloop Endobag Intracorporeal staplers

Each procedure costs 20,000 - 45,000NGN

(125-300USD)

OAUTHC, Ile-Ife 181 consecutive laparoscopic surgeries

Laparoscopic cholecystectomies 48 Laparoscopic appendectomies 36 Laparoscopic evaluation and

biopsy of intra-abdominal tumours 53 Laparoscopic adhesiolysis 18

Laparoscopy assisted colon surgeries 2 Laparoscopic hernia repair 6 Others 18

Outcome

Conversion to open procedure 5/181

Cholecystectomy 1 Hepatic biopsy 1 Complicated appendicitis 2 Colon cancer 1

Port site infections 11/518 Bile duct injury 1 Mortality Nil

Wound outcome

Greetings from Nigeria