Page 11 - World Journal of Laparoscopic Surgery

WJOLS
WJOLS

10.5005/jp-journals-10033-1229
Our Experience in Laparoscopic Appendectomy in Federal Teaching Hospital, Gombe
OriginaL articLe

Our Experience in Laparoscopic Appendectomy in

Federal Teaching Hospital, Gombe

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1 Nuhu Musa Mshelia, SK Obiano, MI Guduf, YS Gital, S Khalifa
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ABSTRACT INTROduCTION
Background: Federal Medical Centre, Gombe is one of the Laparoscopic appendectomy has recently been intro-
tertiary hospitals located in the north east of Nigeria. It serves as
a referral center to neighboring state and also giving secondary duced to our nation though the speed is slow but quite
care to the immediate environment. The institution has evolved a number of procedures have been done as reported in
in giving minimal access surgery services in appendicectomies, Nnewi and Oweri. Until now all procedures of appen-
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cholecystectomies, diagnostic laparoscopy, endourology, etc.
We are presenting our experience in laparoscopic appendec- dectomy were open. Semme K, a gynecologist was the
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tomies. first to remove appendix in 1983 and Schreiber remove
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Objective: To share our experience in laparoscopic appen- an inflamed appendix in 1987. The acceptance of the
dectomy. use of laparoscopy to treat appendicitis has been slow.
Materials and methods: One year review (May, 2013 to This may be attributed to its longer operating time, cost
February, 2014) of patients that underwent laparoscopic appen- and observation made on higher rate of intra-abdominal
dectomy were made. Recruitment for the procedure is done abscesses. More laparoscopic appendicectomies are
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via presentations at the emergency department (ED) or at the 5
surgical outpatient department (SOPD). All cases that had being performed than open in Australia. The trend is
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complications and previous abdominal surgeries or had cardio- toward a single incision laparoscopy surgery using the
pulmonary disease are excluded. Patients were counseled and umbilicus to perform procedures. Navarra et al started
taken written consent for conversion to open.
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the single incision to perform cholecystectomy in 1997
Results: Twenty patients were reviewed that had laparo- and since the many other surgeries like appendectomy
scopic appendectomy. All had successful surgery; there was 7
no conversion to open. Mean operative time is 34.2 minutes; among others are done with successes.
mean recovery period is 181 minutes (3 hours), mean pain Those that will benefit from a laparoscopic appendec-
perception was 2.55 (mild pains), mean hospital stay was tomy are:
22 hours. They were followed up at the SOPD and none of
them had ports sites wound infection or clinical evidence of a. Acute or chronic right lower abdominal pain with
other complications. doubtful diagnosis of acute appendicitis. A diagnostic
laparoscopy is done.
Conclusion: Laparoscopic appendectomy is a favorable
option in the treatment of uncomplicated appendicitis. Early b. Vague lower abdominal pains suspected to be appen-
recovery, reduced pain and hospital stay are the outcome dicitis in immune compromised individual.
observed.
c. Obese patient which larger wound is needed to per-
Keywords: Laparoscopy, General surgery unit, Federal form appendectomy.
teaching Hospital, Gombe, Experience.
d. Young females where it may be difficult to differen-
Abbreviations: MOT: Mean operative time; PP: Pain percep- tiate other pathology of the pelvis from appen-
tion; RT: Recovery time; HS: Hospital stay.
dicitis.
How to cite this article: Mshelia NM, Obiano SK, Guduf MI,
Gital YS, Khalifa S. Our Experience in Laparoscopic Appendec-
tomy in Federal Teaching Hospital, Gombe. World J Lap Surg MATERIALS ANd METHOdS
2014;7(3):111-115.
Twenty patients had laparoscopic appendectomy within
Source of support: Nil
the period of review, 8 are males and 12 are females. They
Conflict of interest: None were counseled on the procedure and written consent
was signed including the option of converting to open
appendectomy. Under general anesthesia, intubated and
1,3,4 Consultant, Chief Consultant, Registrar fully relaxed in supine position, surgical team in their
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1-5 Department of Surgery, Federal Teaching Hospital position (Fig. 1), in the female, they may be need to placed
Gombe, Nigeria them in lithotomy position for uterine manipulation
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Corresponding Author: Nuhu Musa Mshelia, Consultant when the need is required. Formal pneumoperitoneum
Department of Surgery, Federal Teaching Hospital, Gombe were achieved. First, laparoscopic visualization were
Nigeria, Phone: 08038045093, e-mail: mshelianuhu@yahoo.com
carried out then placement of second and third ports
World Journal of Laparoscopic Surgery, September-December 2014;7(3):111-115 111