title: Laparoscopic surgery in a Nigerian teaching hospital for 1 year: challenges and effect on outcomes.
abstract: BACKGROUND
  Laparoscopic surgery has developed rapidly in developed nations within a relatively short time to become a major method of treating surgical diseases, with increasing application across specialties. However this is not the situation in developing countries like Nigeria. This may be as a result of local challenges to the performance of laparoscopic procedures. It is important to identify what these challenges are.
  
  
  METHODS
  We prospectively studied problems encountered during the performance of laparoscopic procedures, and their effects on the procedure in a Nigerian teaching hospital for a year. Demographic information, laparoscopic procedure, problems encountered and effect on procedure, and outcomes were analyzed using descriptive statistics.
  
  
  RESULTS
  Our sample consisted of 21 patients who had laparoscopic procedures performed by the authors; 12 (57%) were therapeutic procedures. Average age was 34.1 years (range 18-50 years) and majority (61.9%) were female. Problems encountered included non functioning/malfunctioning equipment (76.2%), power outages (33.3%), and dead light source bulbs (14.3%). There were 5 (23.8%) conversions to open surgery as a result of problems encountered; another conversion (4.8%) was to tackle an ascending colon tumour discovered at laparoscopy.
  
  
  CONCLUSIONS
  The performance of laparoscopic procedures in a Nigerian public hospital is affected largely by inadequate and often malfunctioning equipment, and attention to these may reduce rates of conversion to open surgery.
authors.affiliation: Department of Surgery, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
authors.forename: B O
authors.initials: BO
authors.lastname: Ismaila
authors.forename: S I
authors.initials: SI
authors.lastname: Shuaibu
authors.forename: S I
authors.initials: SI
authors.lastname: Samaila
authors.forename: A A
authors.initials: AA
authors.lastname: Ale
mesh_terms: D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D017063:Outcome Assessment, Health Care; D055815:Young Adult