title: First 100 laparoscopic surgeries in a predominantly rural Nigerian population: a template for future growth.
abstract: BACKGROUND
  Minimal access surgery has revolutionized surgery practice. Its proven advantages, such as reduced postoperative pain, early return to unrestricted activities, and better cosmesis, have become important drivers for its rapid development. In sub-Saharan Africa this development has been slow. The aim of the current study was to describe the challenges and outcomes of laparoscopic procedures in a public hospital that caters to a predominantly rural population.
  
  
  METHODS
  The first 100 patients who underwent laparoscopic procedure in the Department of Surgery at Federal Medical Centre, Owerri, Nigeria were retrospectively analyzed. Data were retrieved from the medical records department as well as the surgical theater procedure register. The focus of the study was on patient demographics, indication for surgery, procedure performed, length of hospital stay, and morbidity and mortality data. Staff training was done locally and abroad.
  
  
  RESULTS
  Altogether, 100 patients had laparoscopic surgery in our general surgery unit from September 2007 through July 2013. The ages of the patients was 5-75 years (median 36.5 years). The three main procedures were cholecystectomy (36 %), diagnostic laparoscopy (29 %), and appendectomy (21 %). The other operations performed included liver abscess drainage (7 %), adhesiolysis (3 %), hernia repair (1 %), and Heller's myotomy (1 %). Four cases were converted to open surgery. There were no deaths. There were 14 grades I and II postoperative complications in nine patients.
  
  
  CONCLUSIONS
  Our study suggests that basic laparoscopic procedures could be offered safely to our resource-poor rural population. It is a platform on which we can hopefully introduce advanced laparoscopic surgical operations.
authors.affiliation: Department of Surgery, Federal Medical Centre, Owerri, Nigeria, chrisekwunife@yahoo.co.uk.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Ekwunife
authors.forename: Ogechukwu
authors.initials: O
authors.lastname: Nwobe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D002648:Child; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D061887:Conversion to Open Surgery; D004322:Drainage / Q000379:methods; D005260:Female; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008100:Liver Abscess / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012189:Retrospective Studies; D012424:Rural Population; D000267:Tissue Adhesions / Q000601:surgery; D055815:Young Adult