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                                                                                10.5005/jp-journals-10033-1263
                                                                              Laparoscopic Appendicectomy in Gombe
          ORIGINAL ARTICLE

          Our Experience in Laparoscopic Appendicectomy in

          Federal Teaching Hospital in Gombe

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          1 Nuhu Musa Mshelia,  SK Obiano,  MI Guduf,  YS Gital,  S Khalifa
          ABSTRACT                                            INTRODUCTION
          Background: Federal Medical Centre, Gombe is one of the   Laparoscopic appendicectomy has recently been intro-
          tertiary hospitals located in the northeast of Nigeria. It serves   duced in Nigeria. Although the speed is slow, quite a
          as  a  referral  center  to  neighboring  states  and  also  gives
          secondary care to the immediate environment. The institution   number of procedures have been performed as reported
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          has evolved in providing minimal access surgery services in  in Ekwunife et al.  Until recently all appendicectomy
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          appendicectomies, cholecystectomies, diagnostic laparoscopy,  procedures were open. Semm,  a gynecologist, was
          endourology, etc. We present our experience in laparoscopic   the first to remove the appendix in 1983 and Schreiber

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          appendicectomies.
                                                              removed an inflamed appendix in 1987. The acceptance
          Objective: To share our experience in general surgery unit in  of the use of laparoscopy to treat appendicitis has been
          laparoscopic surgery.                               slow. This may be attributed to its longer operating time,
          Materials and methods: One-year review (May 2013 to  increased cost, and observation made on higher rate of
          February 2014)  of  patients  who  underwent  laparoscopic   intra-abdominal abscesses.  More laparoscopic appendi-
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          appendicectomy was made. Recruitment for the procedure   cectomies are being performed than open appendicecto-
          was done from patients who presented at the Emergency              5
          Department (ED) or at the Surgical Outpatient Department   mies in Australia.  The trend is toward a single-incision
          (SOPD).  All  patients  who  had  complications  and  previous  laparoscopic surgery using the umbilicus to perform
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          abdominal surgeries or had cardiopulmonary disease were  procedures. Navarra et al  started the single incision
          excluded. Patients were counseled and written consent for   method to perform cholecystectomy in 1997 and since
          conversion to open surgery was obtained.
                                                              then many other surgeries like appendicectomy, among
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          Results: Twenty patients who had laparoscopic appendicectomy   others, are being done with success.
          were reviewed. All had successful surgery; there was no   Patients who will benefit from a laparoscopic appen-
          conversion to open. Mean operative time was 34.2 minutes;
          mean recovery period was 181 minutes (3 hours), mean pain   dicectomy are as follows:
          perception  was  2.55  (mild  pain),  mean  hospital  stay  was     •  Patients with acute or chronic right lower abdominal
          22 hours. They were followed up at the SOPD and none of   pain with doubtful diagnosis of acute appendicitis. A
          them had port site wound infection or clinical evidence of other   diagnostic laparoscopy is done.
          complications.                                      •  Patients with vague lower abdominal pain suspected to
          Conclusion: Laparoscopic appendicectomy is a favorable   be appendicitis in immune-compromised individuals.
          option in the treatment of uncomplicated appendicitis. Early   •  Obese patients in whom larger wound is needed to
          recovery, reduced pain, and reduced hospital stay are the
          outcomes observed.                                     perform appendicectomy.
                                                              •  Young females where it may be difficult to differentiate
          Keywords: Experience, Federal Teaching Hospital, General   other pathology of the pelvis from appendicitis.
          surgery unit, Gombe, Laparoscopy.
          How to cite this article: Mshelia NM, Obiano SK, Guduf MI,    MATERIALS AND METHODS
          Gital YS, Khalifa S. Our Experience in Laparoscopic
          Appendicectomy in a Federal Teaching Hospital in Gombe.  A total of 20 patients had laparoscopic appendicectomy
          World J Lap Surg 2016;9(1):17-21.                   within the period of review, 8 males and 12 females. They
          Source of support: Nil                              were counseled on the procedure and written consent
          Conflict of interest: None                          was obtained including the option of converting to open
                                                              appendicectomy. Under general anesthesia, with the
                                                              patient intubated and fully relaxed in supine position,
            1 Consultant,  Chief  Consultant  Surgeon,  3,4 Consultant   the surgical team is shown in their position (Fig. 1).
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            Surgeon,  Registrar                               Female patients may be placed in lithotomy position
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            1-5 Department of Surgery, Federal Teaching Hospital, Gombe   for uterine manipulation when the need arises.  Formal
            Nigeria                                           pneumoperitoneum was achieved. First, laparoscopic
            Corresponding Author:  Nuhu Musa Mshelia, Consultant   visualization was carried out and then placement of
            Department of Surgery, Federal Teaching Hospital, Gombe, Nigeria   second and third ports under vision in the left lower
            Phone: +08038045093, e-mail: mshelianuhu@yahoo.com
                                                              and right upper quadrants (Figs 2 to 4) for dissection
          World Journal of Laparoscopic Surgery, January-April 2016;9(1):17-21                              17
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