Journal of Surgical Simulation 2021; 8: A: 5 - 5
Published: 30 June 2021
Special Issue: Limitations and challenges of laparoscopic surgery in a low-income country: example of the Gaston Berger teaching Hospital of Saint-Louis (Senegal)
Introduction: Despite the advances in minimally invasive surgery in developed countries, laparoscopy remains less used in low resource settings. Our aim is to describe our first experience in laparoscopic surgery at the Saint-Louis Hospital, Senegal.
Methods: This is a prospective study over the period from November 1, 2018, to June 31, 2020. We included patients operated by laparoscopy. The studied parameters were: age, gender, procedures, operative time, reasons, and rate for conversion, intraoperative difficulties, length of hospital stay and postoperative complications.
Results: We operated 83 patients. The mean age was 33.3 years (11-74). There were 37 men and 46 women. It was emergency interventions in 51.8% and scheduled in 48.2%. The performed procedures were: appendectomy (49.3%), cholecystectomy (18.1%), exploration of infertility (10.8%), exploratory laparoscopy (7%), and TAPP (4.8%). Conversion rate was 9.6% (n=8). The reasons for conversion were technical in 2 cases (CO2 leakage and CO2 disruption), and due to adhesions in 5 cases. The operative difficulties were linked to the adjustment of the electrosurgical unit (n=4), defective trocars (n=2), and defective suction-irrigation unit
(n=1). The mean operative time was 81 minutes (20-210). The average length of hospital stay was 2.7 days (1-8). There were 5 complications (2 surgical site infections, 2 biliary leakages, and 1 caecal fistula). There were 2 deaths (2.4%) (pulmonary embolism and postoperative peritonitis).
Conclusions: Developing minimally invasive surgery in low resource context is a great challenge. To achieve this goal, emphasis must be placed on training the medical team and improving equipment.
laparoscopic surgery; low-resource setting; minimally invasive surgery
This presentation was given at the SES 2020 online conference, 4 July 2020.