Minimally Invasive Surgery in Port Harcourt, Nigeria: Progress So Far

Abstract

Background The global practice of minimally invasive surgery (MIS) has progressed from basic to advanced procedures. Consequent to this, almost all surgical procedures can be performed through a minimally invasive technique. This study aims to audit the practice of MIS in healthcare facilities within a city in a developing country in Africa. Methods This is a multicenter, multispecialty, retrospective descriptive study of minimally invasive diagnostic and therapeutic surgeries performed in private and public health care facilities in Port Harcourt, Rivers State, Nigeria, conducted for a duration of 10 years, from January 2010 to December 2019. A proforma was distributed for completion to identified surgeons from the included study centers. Data on MIS, including types of procedures, time trends, frequency, category of surgery, and cost, were collated. Statistical analysis was performed using IBM Statistical Package for the Social Sciences (IBM SPSS version 20.0, New York, USA). Results There were 5845 minimally invasive procedures performed during the study period, out of which only 92 (1.57%) were carried out in government-owned hospitals. Of these, 2570 were gynecologic (44.0%), 1873 were urologic (32.0%), 1300 were general surgeries (22.2%), 142 were pediatric surgeries (2.4%), and 3 (0.05%) were thoracic minimally invasive procedures performed within the 10-year period. The cost of procedures ranged from <$200 USD to >$2000 USD. The hospital stays ranged from <1 day to a maximum of 13 days. Conclusion The practice of MIS has made significant progress but has been primarily driven by the private sector. Subsidizing the cost of MIS procedures in government-owned hospitals is likely to improve patronage and improve the skills of surgeons.

Current state of minimally invasive general surgical practice in Africa: A systematic review and meta‐analysis of the laparoscopic procedures performed and outcomes

“…5052 were excluded at this point as they did not meet the inclusion criteria. 296 were subsequently screened at full text level to determine eligibility, and a total of 40 studies 1,7,8,19–55 published across 15 African countries were included in this study (Figure 1).…”

Urological surgeries in a West African Teaching Hospital

“…The vast majority of such cases are being treated in private facilities around the country. [ 6 7 8 27 ] Many challenges are responsible for this ranging from a lack of political goodwill to fund the tertiary hospitals with state-of-the-art endourology sets to a lack of maintenance culture and lack of trained manpower to operate these equipment. [ 9 10 ]…”

“…[ 5 ] The use of this technology in Nigeria is evolving, with majority of the minimally invasive surgeries being carried out in private facilities. [ 6 7 8 ] This difference in use of endoscopy between high- and low-income countries revolves around physical availability of trained specialists, lack of basic facilities such as water, electricity to use these instruments and lack of funding of the hospitals. [ 5 9 , 10 ]…”

Impact of Gross Domestic Product (GDP) on the practice of minimally invasive urological surgery and the role of international cooperation: the current situation in Africa, 2023

“…9 In Nigeria, for example, few public hospitals offer basic endourology, with most procedures performed in private facilities. 28 Although in low-income countries the adoption of endourology is low and open surgeries are still widely practiced, minimally invasive and endourological procedures for the treatment of urological diseases are commonly practiced in high-income countries. 29,30 It should be noted that the practice of endourology and minimally invasive surgery brings safety to both the patient and the surgeon.…”