An Audit of Laparoscopic Surgery in a Developing Country in East Africa at the Beginning of a Surgeon’s Learning Curve

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An Audit of Laparoscopic Surgery in a Developing Country in East Africa at the Beginning of a Surgeon’s Learning Curve

April 28, 2021 Medicine and Medical 0

Background: Laparoscopic surgery has been used for surgical access in a variety of situations. The gold standard treatment for cholecystitis in the West is laparoscopic cholecystectomy. Laparoscopic appendicectomy, on the other hand, has sparked debate due to its high cost and time-consuming existence, as well as the numerous trocar sites, which all add up to the duration of an open appendicectomy incision.Laparoscopic surgery has many benefits, including a faster return to daily life, a shorter hospital stay, and less postoperative analgesia. The aim of this study is to evaluate the initial experience of laparoscopic units in a developing country in East Africa.

The thesis was performed retrospectively in the Department of Surgery. This research included all patients who agreed to laparoscopic cholecystectomy and laparoscopic appendicectomy within the first 13 months.

Ten (10) patients consented to laparoscopic cholecystectomies with a male:female ratio of 1:2.33, and twenty (20) patients consented to laparoscopic appendicectomies with a male:female ratio of 1:1.2. The average operating time for laparoscopic cholecystectomy was 58.5 minutes and for laparoscopic appendicectomy was 40.45 minutes. For laparoscopic cholecystectomy, post-operative admission lasted 3 to 5 days, with a mean of 4.2 days, and for laparoscopic appendicectomy, it lasted 2 to 5 days, with a mean of 2.65 days. Aside from a spinal headache in two patients (2.6 percent) out of the total laparoscopic procedures, no other complications were identified. During the one-month follow-up period, there were no readmissions.

Conclusions: Laparoscopic cholecystectomy and appendicectomy are safe and allow for early discharge. The low incidence of cholecystitis in Uganda, relative to the higher incidence of appendicitis, supports the use of laparoscopic appendicectomy for hand and eye coordination training rather than cholecystectomy. The surgeons’ initial cases of laparoscopic procedures have shown an acceptable degree of protection, indicating that laparoscopic appendicectomy is a viable option for learning the fundamentals of laparoscopic surgery.

Author (s) Details

Richard Wismayer
Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda and Department of Surgery, Habib Medical School, IUIU University, Kampala, Uganda.

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