Gynecological Endoscopic Procedures in a Tertiary Hospital in South-West Nigeria

Abstract

Background: After several years of struggling due to many constraints, centers in Nigeria are now performing Gynecological Endoscopy (GE) procedures. This study describes the outcome of various GE procedures in patients with gynecological complaints in a tertiary hospital in South-West Nigeria. Materials and Methods: This study was a prospective longitudinal design. All eligible patients who had endoscopic procedures in the unit between May 2014 and April 2019 were recruited. Excluded were those who refused to take part in the study. The participants were followed up for a year. Data were collected during the preoperative, intraoperative, and postoperative periods. This data included the patient's sociodemographic characteristics, indications for the procedures, procedures carried out, and the procedures' outcome. Results: Of the 287 patients who had various procedures during this period, we recruited two hundred and seventy eligible patients (94.1%) for the study. We lost fourteen patients (5.2%) to follow up. One hundred and seventy-two (63.7%) had laparoscopy only. Eighty (29.6%) had hysteroscopy and laparoscopy, while the remaining 20 (6.7%) had hysteroscopy only. Thirty-eight (14.1%) were emergencies, while 125 (46.3%) were only diagnostic. Procedures carried out include hysteroscopic removal of missing intrauterine devices (6.3%) and laparoscopic tubal sterilization with Falope ring application (5.2%). We also carried out laparoscopic ovarian drilling for polycystic ovary syndrome (19.3%). Six patients (2.2%) had their surgery converted to laparotomy. We recorded no mortality. Conclusion: Our results showed the feasibility of GE surgery in Nigeria with an acceptable outcome. Local adaption and improvisation will ensure cost reduction and widespread use of these procedures in our setting.

Gynaecological Pan-endoscopy (Hystero-laparoscopy) in a tertiary health facility in Nigeria: A ten-year clinical audit

“…Room air can also be used safely with minimal complications, especially in low-resource settings like ours (22)(23)(24). Although cheaper and readily available, room air is associated with poorer visibility, increased risk of wound infection, and abdominal discomfort compared with Carbon dioxide (25)(26)(27). Other gases that can be used are Nitrous oxide, Helium, and Xenon (21).…”

Facing the challenges of gynaecological endoscopic surgical practice in Nigeria: A review

“…A study by Onoh et al 16 in Southeast Nigeria showed that the major challenges bedeviling endoscopy were: late report of endoscopic-related cases, inadequate equipment, lack of maintenance, unstable power supply and wrong notion by the population. However, Fehintola et al 20 in a study in Southwest Nigeria, reported zero mortality in 287 patients that underwent various degree of endoscopic interventions and thus documented local adaptation and improvised approach as the ways to make endoscopy affordable and easily accessible.…”