Pathway to Independence: Implications for Developing A Sustainable MIS Program in low Resource settings.
BACKGROUND
Gastrointestinal surgery has been at the forefront of advances in minimally invasive surgery (MIS). In the low resource settings of the developing countries, despite the benefits of MIS, its uptake in sub-Saharan African countries has been slow.


OBJECTIVE
The present study reports the process of developing a minimally-invasive surgery service line as well as surgical outcomes in LASUTH. METHODS. We reviewed medical records of all patients who underwent minimally invasive surgery at LASUTH between March 2011 and March 2012. During each of three training missions in LASUTH patients with Gastrointestinal and gynaecological surgical conditions were carefully selected, and prepared for surgery. All patients were admitted a day prior to surgery. A description of the surgical technique and the skills training used is also presented.


RESULTS
A total of 24 laparoscopic procedures were performed between March 2011 and March 2012. There were more females 17(70.8%) than males 7(29.2%), with a female to male ratio of 2.5:1. The age range was from 18 yrs to 75 yrs with a peak in the age group between 21-30 yrs. The chief complaints were right hypochondrial pain in 9 cases (37.5%) and right iliac fossa pain in 6 cases (25%) whilst others were right groin swelling, dysphagia, infertility and intersex state.


CONCLUSIONS
The results presented in respect of conversion rate, length of post operative stay and complications rate are similar to the pattern in more established centers. The use of team training as done in LASUTH helps to accelerate the rate of learning and ensures sustainability.
Department of Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos. boludara2001@yahoo.com
Oludara
O
Mobolaji
Nwariaku
N
Fiemu
Ibrahim
I
Akanmu
Pursnani
P
Kish
Williams
W
Omolara
Omodele
O
Foluso
Osuoji
O
Roland
Ikuerowo
I
Stephen
Aderounmu
A
Adebimpe
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D005831:Genital Diseases, Female / Q000601:surgery*; D006295:Health Resources; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000193:education / Q000592:standards; D009549:Nigeria / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D016730:Program Development