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EXPERIENCE WITH LAPAROSCOPIC SURGERY AT THE AGA KHAN HOSPITAL, NAIROBI
Abstract
ABSTRACT
Objective: To outline the experience of laparoscopic surgery at the Aga Khan Hospital,
Nairobi, and to determine the acceptability and outcome of the various procedures
undertaken laparoscopically.
Design: A retrospective case analysis.
Subjects: Four hundred and seventy eight cases of laparoscopic surgery were undertaken
in Nairobi from May 2000 to May 2002 in the presence of the principal author, of
these 408 cases (85.35%) were performed at the Aga Khan Hospital in Nairobi. A review
of these cases and their outcomes are analysed and presented.
Exclusions: Loss of client records, or follow up, all diagnostic procedures and all
procedures performed at the three other private hospitals, namely; Nairobi Hospital,
Nairobi Womens’ Hospital and the M.P. Shah Hospital, have been excluded in this review
Results: Minimal access surgery will in time find its place amongst the institutions in
Kenya. In the last two years 408 cases were undertaken at the Aga Khan Hospital,
Nairobi, involving a pool of 48 consultants obstetricians and gynaecologists and general
surgeons. The case load increased from 7.0 cases per month in 2000 to 22 cases per
month in 2001. Sixty four point four six percent of the patients spent one night in
hospital, while 1.96% had conversion to laparotomy intraoperatively. Thirty nine point
seven percent of the patients had no previous surgery. The surgical procedures
performed included laparoscopic adhesiolysis (34.55%) and tuboplasty (17.89%) for
primary or secondary infertility, 33 cases (8.08% ) for the management of ectopic
pregnancies, laparoscopic myomectomy (15.44%), ovarian cystectomy (16.91%), ovarian
drilling (4.65%), laparoscopic assisted vaginal hysterectomy (15.19%) and total
laparoscopic hysterectomy (2.20%). All cases were reviewed by the consultant pool one
week after discharge. The major complications encountered included bladder injury
(0.49%) and gut injury (0.73%).
Conclusions: Minimal access surgery in gynaecology and general surgery is gaining
remarkable ground worldwide and has tremendous potential in Kenya. It is evident
that in trained hands, the common gynaecological operations and certain general
Surgical procedures can be undertaken safely, laparoscopically. Minimal access surgery
is acceptable to the patients and significantly favourable outcomes have been established
in all the cases undertaken, thus far. Patient compliance has been excellent in this series.
Objective: To outline the experience of laparoscopic surgery at the Aga Khan Hospital,
Nairobi, and to determine the acceptability and outcome of the various procedures
undertaken laparoscopically.
Design: A retrospective case analysis.
Subjects: Four hundred and seventy eight cases of laparoscopic surgery were undertaken
in Nairobi from May 2000 to May 2002 in the presence of the principal author, of
these 408 cases (85.35%) were performed at the Aga Khan Hospital in Nairobi. A review
of these cases and their outcomes are analysed and presented.
Exclusions: Loss of client records, or follow up, all diagnostic procedures and all
procedures performed at the three other private hospitals, namely; Nairobi Hospital,
Nairobi Womens’ Hospital and the M.P. Shah Hospital, have been excluded in this review
Results: Minimal access surgery will in time find its place amongst the institutions in
Kenya. In the last two years 408 cases were undertaken at the Aga Khan Hospital,
Nairobi, involving a pool of 48 consultants obstetricians and gynaecologists and general
surgeons. The case load increased from 7.0 cases per month in 2000 to 22 cases per
month in 2001. Sixty four point four six percent of the patients spent one night in
hospital, while 1.96% had conversion to laparotomy intraoperatively. Thirty nine point
seven percent of the patients had no previous surgery. The surgical procedures
performed included laparoscopic adhesiolysis (34.55%) and tuboplasty (17.89%) for
primary or secondary infertility, 33 cases (8.08% ) for the management of ectopic
pregnancies, laparoscopic myomectomy (15.44%), ovarian cystectomy (16.91%), ovarian
drilling (4.65%), laparoscopic assisted vaginal hysterectomy (15.19%) and total
laparoscopic hysterectomy (2.20%). All cases were reviewed by the consultant pool one
week after discharge. The major complications encountered included bladder injury
(0.49%) and gut injury (0.73%).
Conclusions: Minimal access surgery in gynaecology and general surgery is gaining
remarkable ground worldwide and has tremendous potential in Kenya. It is evident
that in trained hands, the common gynaecological operations and certain general
Surgical procedures can be undertaken safely, laparoscopically. Minimal access surgery
is acceptable to the patients and significantly favourable outcomes have been established
in all the cases undertaken, thus far. Patient compliance has been excellent in this series.
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