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.