title: STARTING A LAPAROSCOPIC SURGERY PROGRAMME IN THE SECOND LARGEST TEACHING HOSPITAL IN GHANA.
abstract: BACKGROUND
  Komfo Anokye Teaching Hospital (KATH) is the second largest hospital in Ghana. Two years have elapsed after performance of the first laparoscopic cholecystectomy.
  
  
  OBJECTIVE
  To examine our experience and lessons learned.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Komfo Anokye Teaching Hospital (KATH).
  
  
  METHODS
  We reviewed leadership support, the role of a surgeon champion, training of physician and OR staff, influence of surgeons from outside Ghana and equipment status. The results of laparoscopic cholecystectomies performed from 2010-2012 were compared with information available from open cholecystectomies over the same period.
  
  
  RESULTS
  Evidence of leadership support included equipment purchase and invitation of outside experts yearly from 2008. A KATH surgeon champion was identified in 2010. A dedicated OR team received training and exhibited excellent ownership of equipment preparation. Since 2010, 25 laparoscopic cholecystectomies have been performed, 17 independently by a single surgeon. Average operative time was 1.41 hours and length of stay (LOS) 1.5 days. Conversion rate was 4.0% (1/25). Complication rate was 20.0% (5/25), none involving haemorrhage or injuries to bile ducts or bowel. Median patient satisfaction score was 5 on a scale of 1-5 where 5 is most satisfied. Complication rates and hospital stay were lower than for open cholecystectomy (20.0% vs 34.5%, p > 0.05 and 1.5 days vs 6.6 days, p < 0.001 respectively). Operative times were on average 27 min onger for laparoscopic cholecystectomy (p < 0.01).
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy at KATH has become a reality with less complications rates, shorter LOS, and trends towards improved patient satisfaction. Expanding laparoscopic surgery in Ghana requires its inclusion into residency training programmes and public education about its benefits for both patients and physicians.
authors: A
authors: A
authors: Gyedu
authors: J
authors: J
authors: Bingener
authors: C
authors: C
authors: Dally
authors: J
authors: J
authors: Oppong
authors: R
authors: R
authors: Price
authors: K
authors: K
authors: Reid-Lombardo
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D005869:Ghana; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012189:Retrospective Studies