Conference abstract
Accessibility of laparoscopic surgery in urology in Douala, Cameroon
Pan African Medical Journal - Conference Proceedings. 2023:17(58).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.58.1688
Archived on: 04 Jun 2023
Contact the corresponding author
Keywords: Accessibility, laparoscopic surgery, urology, Douala
Oral presentation
Accessibility of laparoscopic surgery in urology in Douala, Cameroon
Nwaha Makon Axel Stephane1,2,&, Mbouche Landry1, Nouboudem Basso Simplice Eclador3, Essola Basile3, Mbem Ngom Pierre1, Njinou Ngninkeu Bertin4, Angwafo III Fru1
1Faculty of Medicine and biomedical Sciences of the University of Yaoundé I, Cameroon, 2Laquintinie Hospital, Douala, Douala, Cameroon, 3Faculty of Medicine and Pharmaceutic Sciences of the University of Douala, Douala, Cameroon, 4Centre Médico-Chirurgical d´Urologie de Bali, Douala, Cameroun
&Corresponding author
Introduction: laparoscopic surgery is a minimal-invasive surgical approach, consisting in performing an operation without a large parietal opening, unlike laparotomy. Still, in full development in Africa, it is progressively investing in all fields of surgery but is very little practiced in urology. We proposed to present and evaluate the accessibility of laparoscopic surgery in urology in Douala.
Methods: this was a multicentre descriptive cross-sectional study in the city of Douala over a period of 65 months, from January 2016 to May 2021. It included complete recorded files of patients who had undergone urology laparoscopy and patients admitted and managed by laparoscopic surgery for urological pathology. We excluded incomplete recorded files and patients who withdrew their consent.
Results: we selected 26 patients and 160 recorded files of patients operated on by laparoscopic surgery in urology. The hospital prevalence was 8.1% with a predominance; the male/female sex ratio was 5.4. The mean age was 44.6 ± 17.5 years. Subjects over 55 years of age were the most represented. Varicocele surgery for infertility was the most common laparoscopic procedure in urology with 37.6%. Dissection-clipping of the spermatic cord vessels in the case of varicocele with 29.6% was the most performed procedure. Among the laparoscopic approaches, the most used was the tans-peritoneal approach in 92.5% of cases (172 cases). The main intraoperative complication was found to be a vascular lesion (4 cases). One case of indicated conversion due to intraoperative bleeding was recorded during testicular lowering. Surgical procedures lasted on average 1.5 ± 0.5 hours, with extremes ranging from 0.3 to 3.1 hours. The post-operative complication rate was 8.1%, dominated by post-operative infection at 2.7%. The average hospital stay was 2.3 ± 1.4 days. More than half of the operated cases resumed their activities within 2 weeks. The cost of the operations varied between 200 000 XAF (325usd) and 2 500 000 XAF (4000usd) depending on the hospital structures.
Conclusion: laparoscopic surgery is poorly practiced in urology in our environment due to a multifactorial association including skills, technical facilities, and the cost of care. Despite the multiple indications, its practice and accessibility remain limited. We recommend funding the field of urological laparoscopy to promote its development.
Accessibility of laparoscopic surgery in urology in Douala, Cameroon
Nwaha Makon Axel Stephane1,2,&, Mbouche Landry1, Nouboudem Basso Simplice Eclador3, Essola Basile3, Mbem Ngom Pierre1, Njinou Ngninkeu Bertin4, Angwafo III Fru1
1Faculty of Medicine and biomedical Sciences of the University of Yaoundé I, Cameroon, 2Laquintinie Hospital, Douala, Douala, Cameroon, 3Faculty of Medicine and Pharmaceutic Sciences of the University of Douala, Douala, Cameroon, 4Centre Médico-Chirurgical d´Urologie de Bali, Douala, Cameroun
&Corresponding author
Introduction: laparoscopic surgery is a minimal-invasive surgical approach, consisting in performing an operation without a large parietal opening, unlike laparotomy. Still, in full development in Africa, it is progressively investing in all fields of surgery but is very little practiced in urology. We proposed to present and evaluate the accessibility of laparoscopic surgery in urology in Douala.
Methods: this was a multicentre descriptive cross-sectional study in the city of Douala over a period of 65 months, from January 2016 to May 2021. It included complete recorded files of patients who had undergone urology laparoscopy and patients admitted and managed by laparoscopic surgery for urological pathology. We excluded incomplete recorded files and patients who withdrew their consent.
Results: we selected 26 patients and 160 recorded files of patients operated on by laparoscopic surgery in urology. The hospital prevalence was 8.1% with a predominance; the male/female sex ratio was 5.4. The mean age was 44.6 ± 17.5 years. Subjects over 55 years of age were the most represented. Varicocele surgery for infertility was the most common laparoscopic procedure in urology with 37.6%. Dissection-clipping of the spermatic cord vessels in the case of varicocele with 29.6% was the most performed procedure. Among the laparoscopic approaches, the most used was the tans-peritoneal approach in 92.5% of cases (172 cases). The main intraoperative complication was found to be a vascular lesion (4 cases). One case of indicated conversion due to intraoperative bleeding was recorded during testicular lowering. Surgical procedures lasted on average 1.5 ± 0.5 hours, with extremes ranging from 0.3 to 3.1 hours. The post-operative complication rate was 8.1%, dominated by post-operative infection at 2.7%. The average hospital stay was 2.3 ± 1.4 days. More than half of the operated cases resumed their activities within 2 weeks. The cost of the operations varied between 200 000 XAF (325usd) and 2 500 000 XAF (4000usd) depending on the hospital structures.
Conclusion: laparoscopic surgery is poorly practiced in urology in our environment due to a multifactorial association including skills, technical facilities, and the cost of care. Despite the multiple indications, its practice and accessibility remain limited. We recommend funding the field of urological laparoscopy to promote its development.
