Pediatric laparoscopic surgery in North-Central Nigeria: Achievements and challenges

Abdur-Rahman, Lukman O.; Bamigbola, Kayode T; Nasir, Abdulrasheed A; Oyinloye, Adewale O.; Abdulraheem, Nurudeen T; Oyedepo, Olanrewaju Olubukola; Adeniran, James O.

doi:10.4103/2468-6859.192271

Cited by 4 publications

(3 citation statements)

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“…[ 4 5 6 8 ] Laparoscopic surgery is becoming increasingly popular in Sub-Saharan Africa for the evaluation and treatment of infertility. [ 10 11 12 ] The laparoscopic grading of adhesions is useful for careful decision-making regarding the extent of repeat operative procedures including adhesion removal. [ 13 14 ] There have been attempts at grading adhesions, but the Coccolini peritoneal adhesion index (PAI) is a quick easy-to-apply gross scoring system, which combines the regional anatomy of the peritoneal cavity and the adhesion grade to obtain the PAI.…”

Section: Introductionmentioning

confidence: 99%

Peritoneal adhesion findings during laparoscopy: Determinants of occurrence and effect of severity on operative outcomes in a Nigerian Hospital

et al. 2023

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Context: Peritoneal adhesions unlike other immediately recognizable complications of the surgery may produce long-term consequences, which include infertility and intestinal obstruction. Aims: The study aimed to determine the prevalence, the determinants, and the outcomes of laparoscopic surgery associated with intraperitoneal adhesion findings. Settings and Design: This was a retrospective observational study. Materials and Methods: The study included all laparoscopic gynecological surgeries done between January 2017 and December 2021. Adhesion severity was graded, using the peritoneal adhesion index (PAI), by Coccolini et al . Statistical Analysis: The data were analyzed using the SPSS version 21.0. Binary logistic regression was used to assess the factors associated with adhesion finding during laparoscopy. Results: There were 158 laparoscopic surgeries with 26.6% prevalence of peritoneal adhesions. The prevalence of adhesions among women with previous surgery was 72.7%. Previous peritoneal surgery was a significant determinant of occurrence of adhesions (odds ratio = 8.291, 95% confidence interval [CI] = 4.464–15.397, P < 0.001), and such patients had significantly ( P = 0.025, 95% CI = 0.408–5.704) more severe adhesions (PAI = 11.16 ± 3.94) than those without prior surgery (PAI = 8.10 ± 3.14). Abdominal myomectomy (PAI = 13.09 ± 2.95) was the most important primary surgical determinant of adhesion formation. There was no significant relationship between adhesion occurrence and conversion to laparotomy ( P = 0.121) or mean duration of surgery ( P = 0.962). Greater adhesion severity was, however, observed in individuals with operative blood loss <100 ml (PAI = 11.73 ± 3.56, P = 0.003) and those hospitalized for ≤2 days (PAI = 11.12 ± 3.81, P = 0.022). Conclusion: The prevalence of postoperative adhesions during laparoscopy in our center is comparable to what has been earlier reported. Abdominal myomectomy is associated with the greatest risk and severity of adhesions. Laparoscopy in patients with more severe adhesions resulted in less blood loss and shorter duration of hospitalization, suggesting an association of better outcomes with a cautious approach to adhesions.

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Section: Introductionmentioning

confidence: 99%

Peritoneal adhesion findings during laparoscopy: Determinants of occurrence and effect of severity on operative outcomes in a Nigerian Hospital

et al. 2023

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“…In Nigeria, laparoscopic surgery has not been widely adopted, with very few centres having adequately trained staffs and dedicated surgeons willing to practice paediatric laparoscopic surgery while battling the already significant challenge with managing children with surgical needs. [ 1 2 ] It has been well established that laparoscopic surgery offers significant advantages over open surgery, vis-à-vis early post-operative recovery, less pain and good cosmetic outcome; however, the steep learning curve and the immediate cost of equipment and consumables create significant discouragement to the surgeons in the third world countries. [ 3 4 ]…”

Section: Introductionmentioning

confidence: 99%

Mitigating the challenges of laparoscopic paediatric surgery in Ile Ife: The trend so far and lessons learnt

Igwe¹,

Talabi²,

Adumah³

et al. 2020

Afr J Paediatr Surg

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Background: Paediatric laparoscopic surgery is fast growing worldwide, with many pathologies now being treated even in the youngest of patients. We hereby report our experience with the first 114 cases. Objectives: Our aim was to highlight our progress and lessons learnt practicing laparoscopic paediatric surgery in our institution. Materials and Methods: This is a retrospective study of the first 114 children who underwent laparoscopic surgery in our hospital. We focussed on demographics, indications, procedures performed, rate of conversion to open and complications. Records were retrieved from January 2011 to December 2019. Data were analysed using the SPSS software version 23 (SPSS Inc., Chicago, Illinois, USA). Results: There were 83 males and 31 females (ratio of 3:1). Age groups included infants (13.2%), 1–5 years (21.9%), 5–10 years (33.3%) and > 10 years (31.6%). There was a remarkable increase in the frequency and complexity of cases performed from an average of 5 per year between 2011 and 2015 to an average of 23.5 per year between 2016 and 2019. The conversion rate was 6%, 5 appendectomies, 1 Swenson pull-through, 1 diagnostic laparoscopy and 1 Ladd's procedure. Four complications were noted; one recurrent adhesive intestinal obstruction, one residual intra-abdominal abscess, one port site abscess and one excessive bleeding from liver biopsy requiring conversion to open surgery. Conclusion: We have demonstrated that the routine use of laparoscopy in children is feasible and safe in our environment. However, the need for training, endurance through a steep learning curve and the willingness to battle the technical challenges are necessary for success.

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“…Available reports indicate the practice of laparoscopy in some Nigerian postgraduate training centers. [567] There is paucity of information on the level of exposure and participation of Nigerian postgraduate trainees in laparoscopy. This study, therefore, aimed at assessing the level of exposure and training experience of surgical residents in accredited training institutions in Nigeria in basic laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

Survey of basic laparoscopic training exposure of Nigerian postgraduate trainees

et al. 2019

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Background:The practice of laparoscopy involves the use of training models that are different from conventional open surgery. These concepts are not captured in the traditional models of surgical residency training. Residency training in surgery has been seen as an ample opportunity for early introduction and training in laparoscopy.Objectives:This study aimed to assess the level of exposure and training experience of some surgical resident doctors in accredited training institutions in Nigeria on laparoscopy.Methodology:A cross-sectional survey was conducted among the resident doctors undergoing revision course in surgery at the National Orthopaedic Hospital, Igbobi, Lagos, and Lagos University Teaching Hospital, Lagos, in March 2018. Using the quantitative method of data collection, a pre-tested structured questionnaire was used to collect information on the demography and training exposure of the residents in laparoscopy.Results:A total of 54 of 96 residents surveyed returned the questionnaire, giving a response rate of 56%. There were 53 (98.1%) males and 1 (1.9%) female. The age range of the respondents was between 30 and 46 years, with a mean of 34.2 ± 3.96 years. Thirty-two (59.3%) respondents had spent at least 2 years training in surgery. Thirty-six (66.7%) respondents had not participated in more than four laparoscopic procedures during their rotation. Forty-six percent of respondents reported that their experience in laparoscopy was mainly by observation of the procedures. Forty-nine (90.7%) of respondents surveyed had not attended any training program in laparoscopy. Eighty-one (81.0%) of respondents had a strong motivation and desire for future practice of laparoscopy.Conclusion:This study revealed that few Nigerian postgraduate trainees sampled in the survey were exposed and had training experience in laparoscopy.

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Pediatric laparoscopic surgery in North-Central Nigeria: Achievements and challenges

Cited by 4 publications

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Peritoneal adhesion findings during laparoscopy: Determinants of occurrence and effect of severity on operative outcomes in a Nigerian Hospital

Peritoneal adhesion findings during laparoscopy: Determinants of occurrence and effect of severity on operative outcomes in a Nigerian Hospital

Mitigating the challenges of laparoscopic paediatric surgery in Ile Ife: The trend so far and lessons learnt

Survey of basic laparoscopic training exposure of Nigerian postgraduate trainees

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