Experiences and challenges of gynecological endoscopy in a low-resource setting, Southeast Nigeria

RobinsonC Onoh, PaulO Ezeonu, Lucky Osaheni Lawani, LeonardO Ajah, HyginusU Ezegwui, BornifaceN Ejikeme
In: Tropical Journal of Obstetrics and Gynaecology · 2018 · vol. 35(1) , pp. 30 · doi:10.4103/tjog.tjog_34_17 · W2807919061
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This prospective study analyzed 73 gynecologic endoscopic surgeries in Nigeria, finding dye tests most common, with challenges including equipment shortages, power supply issues, and patient factors.

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Abstract

Background: The scope of endoscopy is expanding more and more as experience is gained with training and collaborations, however, these expansions could be slowed by challenges.Objectives: To determine the experiences and challenges of gyne-endoscopic surgery.Materials and Methods: This study was a prospective analysis of all women undergoing gynecologic endoscopy at Federal Teaching Hospital Abakaliki (FETHA), Nigeria from 2012 to 2014. Patients were recruited based on eligibility for endoscopy surgery. Written informed consent was obtained before any of the gyne-endoscopic surgery. Ethical approval for the study was given by the ethics and research committee of FETHA. Laparoscopy and hysteroscopy were performed by the managing team. EPI Info version 3.5.1 statistical software (Atlanta, GA, USA) was used for data analysis.Results: Seventy-three different gyne-endoscopic surgeries were done, with dye test accounting for majority 28 (77.8%). The duration of surgery ranged from 23 to 248 minutes, and the surgery with the longest duration was total laparoscopic hysterectomy while laparoscopy and dye test had the shortest operating time. The mean duration of hospitalization was 20.3 ± 14.4 hours. There were 2 (5.6%) conversions to open surgery. Most common complication was abdominal pain 26 (72.2%). The challenges include third party partnership, lack of vital equipment, poor maintenance, epileptic power supply, late presentation of cases, and misconception.Conclusion: Gyne-endoscopy is essential in contemporary medicine. Reduction in operating time occurs as skills and experience improve; the challenges are many.

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