Preliminary report of experience with gynaecologic laparoscopy in Ogbomoso, Nigeria

Gynaecologic laparoscopy (GL) had remained in latency in Nigeria because of widespread lack of equipment and skilled personnel. This study presents a pioneer experience with laparoscopic procedures in Gynaecological unit of the Bowen University Teaching Hospital (BUTH), Ogbomoso, Nigeria. Consecutive patients who had laparoscopic procedures from May 2014 to April 2015 were prospectively studied. There were 52 GLs, making up 28.1 % of the 185 gynaecologic surgeries over the study period. The patients’ ages ranged from 18 to 50 years (mean age = 32.6 ± 6.0 years). Eighteen (34.6 %) of the GLs were emergencies, whereas 34 (63.4 %) were elective. Fifteen patients (28.8 %) had only diagnostic laparoscopy for various gynaecological conditions. Eight patients (15.4 %) had tubal surgery for tubal factor infertility. Two patients (3.9 %) had bilateral tubal occlusion as permanent method of contraception. There were 6 salpingectomies for ectopic pregnancy (11.5 %) and three (5.8 %) excision of endometriosis nodules. Nine (28.9 %) ovarian cystectomies and 6 (11.5 %) laparoscopic adhesiolysis were also performed. There were 2 (3.8 %) laparoscopic ovarian drilling for polycystic ovary syndrome and 1 (1.9 %) laparoscopic retrieval of a translocated IUCD. The duration of surgery ranged from 45 to 150 min (mean time = 76.6 ± 32.55 min). Various improvisations and local adaptations were necessary in the course of 14 procedures (27.5 %). There were 2 conversions to laparotomy (3.8 %), all following emergency laparoscopy. There was no major complication despite the challenging intraoperative adverse conditions. The duration of hospital stay postoperatively ranged from 4 h to 4 days (median time = 11 h). There was no mortality. On the basis of our experience, we are of the opinion that gynaecologic laparoscopy procedures can be performed routinely in Nigerian hospitals with acceptable outcome. We advocate the local adaptation of equipments in our environment to ensure sustainability. Similar content being viewed by others

Hurd WW. Gynecologic laparoscopy. E-medicine, July 24,2007. Available @:http://www.emedicine.com/med/topic. Accessed on 10th June 2009 Magos A (2007) Hysteroscopy and laparoscopy. In: Edmonds DE (ed) Dewhurst’s textbook of obstetrics and gynaecology, 7th edn. Blackwell, pp 560–77 Mishra KK. Diagnostic laparoscopy. Laparoscopy Hospital. Available online @:http://www.laparoscopyhospital.com. Accessed on 18th April 2009 Banerjee S, Ballard K, Lovell D, Wright J (2006) The response to radical laparoscopic excision in the treatment of chronic pelvic pain. Gynaecoloc Surgery 3(1):S25 Hudson and Setchell. Minimal access surgery. In: Shaws Textbook of Operative Gynaecology 6th Ed. Elsevier Publication, 2010 pp. 79–94 Akinbiyi AA (2005) Gynaecological operative endoscopy. In: Kwawukume EY, Emuveyan EE (eds) Comprehensive gynaecology in the tropics. Graphic Packaging Limited, Accra Audu I (2009) Benign and malignant ovarian tumours. In: Ikpeze OC (ed) Fundamentals of obstetrics and gynaecology. Africana First Publishers PLC, Onitsha, Nigeria El-Tabbakh MN, Amin AM. Diagnostic laparoscopy in gynaecological problems: a retrospective study. Available@http://www.obgyn.net/hysteroscopy/articles/dx.lap. Accessed on 16th January 2010 Umar-Sulayman H, Ameh N, Adesiyun AG, Ozed-Williams C, Ojabo A, Avidime S, Yusuf A, Enobun N, Muazu A. Laparoscopy in Ahmadu Bello University Teaching Hospital, Zaria. The 40th Annual Conference of SOGON@ International Conference Centre, Abuja,21st – 25th November 2006 Otolorin EO, Ojengbede O, Falase EO (1987) Laparoscopic evaluation of tuboperitoneal factor in infertile Nigerian women. Int J Gynaecol Obstet 25:47–52 Sagay AS, Udoeyop EU, Pam IC, Karshima JA, Daru PH, Otubu JAM (1998) Laparoscopic evaluation of 1000 consecutive infertile women in Jos, Nigeria. Trop J Obstet Gynaecol 15(1):30–35 Yakasai IA, Abdullahi J, Omole-Ohonsi A, Ibrahim SA (2012) Gynaecologic laparoscopy at Aminu Kano Teaching Hospital, Kano, Nigeria: A 5-Year Review. Br J Sci 5(1):11–17 Eskenazi B, Warner ML (1997) Epidemiology of endometriosis. Obstet Gynecol Clin North Am 24:235–58 Hilal MA, Underwood T, Taylor MG, Hamdan K, Elberm H, Pearce NW (2010) Bleeding and hemostasis in laparoscopic liver surgery. Surg Endosc 24:572–577 Victorzon M, Tolonen P, Vuorialho T (2007) Day-case laparoscopic cholecystectomy: treatment of choice for selected patients? Surg Endosc 21:70–73 Psaila J, Agrawal S, Fountain U, Whitfield T, Murgatroyd B, Dunsire MF et al (2008) Day surgery laparoscopic cholecystectomy: factors influencing same day discharge. World J Surg 32:76–81 Udwadia TE, Udwadia RT, Menon K, Kaul P, Kukreja L, Jain R et al (1995) Laparoscopic surgery in the developing world; an overview of the Indian scene. Int Surg 80:371–5 Yung E, Gagner M, Pomp A, Dakin G, Milone L, Strain G (2010) Cost comparison of reusable and single-use ultrasonic shears for laparoscopic bariatric surgery. Obes Surg 20:512–8 Schaer GN, Koechli OR, Haller U (1995) Single-use versus reusable laparoscopic surgical instruments: a cost analysis. Am J Obstet Gynecol 173:1812–1815 Traverso LW, Hargrave K (1995) A prospective cost analysis of laparoscopic cholecystectomy. Am J Surg 169:503–506 Demoulin L, Kesteloot K, Penninck F (1996) A cost comparison of disposable versus reusable instruments in laparoscopic cholecystectomy. Surg Endosc 10:520–525 Adler S, Scherrer M, Rückauer KD, Daschner FD (2005) Comparison of economic and environmental impacts between disposable and reusable instruments used for laparoscopic cholecystectomy. Surg Endosc 19:268–272 Esayas R, Shumey A, Selassie KG (2015) Laparoscopy surgery in a Government Teaching Hospital: an initial experience from Ayder Referral Hospital in Northern Ethiopia. East Cent Afri J Surg 20(1):49–54

I am using this opportunity to acknowledge useful contributions from Drs Olufemi Ogundele and funmito Fehintola of the Community Health Department, Obafemi Awolowo University Ile Ife, Osun State. Nigeria for inputs in the writing of this article. Consent Written informed consent was obtained from each of the patients before the surgery. Outmost confidentiality was ensured since patient’s personal data were not made public in this publication. Each patient gave their consent on making the video coverage available at anytime for review. Ethical clearance Ethical clearance was given by the ethical committee of the hospital for this publication. Conflict of interest The authors declare that they have no competing interests. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Fehintola, A.O., Awotunde, O.T., Ogunlaja, A.O. et al. Preliminary report of experience with gynaecologic laparoscopy in Ogbomoso, Nigeria. Gynecol Surg 13, 17–21 (2016). https://doi.org/10.1007/s10397-015-0906-4 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10397-015-0906-4