Abstract 11.2.2



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Gynaecologic Laparoscopy in Kano Nigeria



Department of Obstetrics and Gynaecology Bayero University /Aminu Kano Teaching Hospital Kano Nigeria



Abstract: Laparoscopy has evolved over the past several decades to become a veritable tool for the Gynaecologist. The scope ranges from diagnostic to operative procedures including urogynaecological surgeries. The pattern varies widely across the globe, being largely diagnostic in the developing countries of sub-Saharan Africa. The aim of this study was to determine the incidence, indications, findings and complications at laparoscopy in Aminu Kano Teaching Hospital, Kano (AKTH), Nigeria over a 5-year period. Case files of all patients who had gynaecologic laparoscopic procedures done in AKTH, between 1st January 2005 and 31st December 2009, were analysed for indications, findings and complications. A total of 182 gynaecologic laparoscopies were done over the study period constituting 1.4% of all surgeries in the hospital; 3.4% of all surgeries in the department of Obstetrics and Gynaecology and 12% of all gynaecologic procedures. All except one were diagnostic. The mean age of the patients was 26.5years with a range of 15-45years.Secondary infertility was the most common indication for laparoscopy (50.7%) followed by primary infertility (30.8%), primary amenorrhea (7.5%) and secondary amenorrhea (2.7%). Findings at operation were bilateral tubal block (44.5%), unilateral tubal block (17.8%) and normal tubes (13.7%). Others include pelvic adhesions (34.9%), Hypoplastic uteri and streak gonads (8.9%), peri-hepatic adhesions (6.2%) and frozen pelvis (5.5%).The complications were upper abdominal pain (4.8%) and chest pain (2.7%). Problems encountered include failed insufflations in one patient, cervical stenosis in three and one mortality during induction of anaesthesia. In conclusion, laparoscopy in Aminu Kano Teaching Hospital is mainly diagnostic and represents 12% of all elective gynaecologic operations. It is associated with low morbidity and there is a low level of expertise in gynaecologic endoscopy in our environment.


Keywords: Laparoscopy, indications, findings, complications, Amino Kano Teaching Hospital.


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