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

SAGES 2012 San Diego, CA. 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, &

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

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  1. SAGES 2012 San Diego, CA Local Adaptations Aid Establishment Of Laparoscopic Surgery In A Semi-urban Nigerian HospitalAO Adisa, OO Lawal, OA Arowolo, OI Alatise. AdisaAdewaleMBChB, FWACS, FMCS(Nig.), D.MAS Department of Surgery, ObafemiAwolowo University, & ObafemiAwolowo University Teaching Hospitals Complex Ile-Ife 220005, Nigeria E mail: wadisc@yahoo.com

  2. SAGES 2012 Disclosure Slide AO Adisa OO Lawal OA Arowolo OI Alatise Nothing To Disclose

  3. Laparoscopic Surgery in Nigeria • Decades of diagnostic procedures • Gynecological procedures • Visiting Surgeons • Few private centers, occasional practices

  4. 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

  5. 2 1 4 3

  6. OAUTHC, Ile-Ife

  7. 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)

  8. OAUTHC, Ile-Ife • 181 consecutive laparoscopic surgeries • Laparoscopic cholecystectomies48 • Laparoscopic appendectomies 36 • Laparoscopic evaluation and biopsy of intra-abdominal tumours53 • Laparoscopic adhesiolysis18 • Laparoscopy assisted colon surgeries 2 • Laparoscopic hernia repair 6 • Others 18

  9. 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

  10. Wound outcome

  11. Greetings from Nigeria

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