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Laparoscopic surgery in the Cameroon
International Journal of Gynecology & Obstetrics 65 Ž1999. 65]66
Brief communication
Laparoscopic surgery in the Cameroon J. Raigaa,U , J.M. Kasiab, M.A. Bruhat c a Department of Obstetrics and Gynecology, Hopital Ci¨ il, Strasbourg, France ˆ Department of Obstetrics and Gynecology, Hopital General ˆ ´ ´ de Yaounde, ´ Yaounde, ´ Cameroon c Department of Obstetrics and Gynecology Reproducti¨ e Medicine, Clermont Ferrand, France
b
Received 21 April 1998; received in revised form 15 September 1998; accepted 23 September 1998
Abstract A new surgical section of operative laparoscopy was installed in General Hospital of Yaounde, ´ Cameroon, in April 1992 after many years of collaboration between the University of Clermont]Ferrand and the University of Yaounde. ´ A total of 735 laparoscopic operations were conducted in the first 5 years. Conditions facilitating such a project are discussed. Q 1999 International Federation of Gynecology and Obstetrics. Keywords: Gynecology; Laparoscopy; Sterility; Cameroon; Africa
1. Introduction A laporoscopic surgery unit was created in 1992 as part of the Gynecology Department at the Yaounde ´ General Hospital, Cameroon. The installation of this unit was the result of close collaboration between the University of Yaounde ´ and that of Clermont]Ferrand, France w1x. The unit has been open since 1992 and has carried out 735 operations laporoscopically. This experience leads us to reflect on the use of this technique in an African country and on the necessary conditions for such an installation.
2. Materials and methods The laporoscopic surgery unit was created in 1992 within the Gynecology Department of the Yaounde ´ General Hospital, Cameroon. v
v
U
Corresponding author.
The surgical team consisted of a Cameroonian Gynecologist who had trained for 7 years in laparoscopic surgery under Prof. Bruhat in the department of gynecology at Clermont]Ferrand. The anesthetists and theater staff had all benefited from several months training in the same department. The laparoscopy equipment: a complete column was kindly funded by Storz.
0020-7292r99r$20.00 Q 1999 International Federation of Gynecology and Obstetrics. PII: S 0 0 2 0 - 7 2 9 2 Ž 9 8 . 0 0 2 0 6 - 9
J. Raiga et al. r International Journal of Gynecology & Obstetrics 65 (1999) 65]66
66 v
The cost to the patient of a laparoscopic operation was worked out as 100 000 francs CFA, or US$ 200. This included the price of the operation plus average hospital stay of 3 days.
3. Results
1. A total of 735 laparoscopic operations were carried out between the 1 May 1992 and 1 May 1996. 2. Sterility remains the most frequent indication: 497 cases Ž67.6%.. 3. The laparoscopic findings were marked by the frequency of pelvic adhesions. A study of the first 194 patients operated on showed encouraging results 2 years later w2x: 45 intra-uterine pregnancies Ž23.2%. and 8 ectopic pregnancies Ž4.1%.. 4. Other indications representing 238 cases Ž32.4%. included 79 ovarian cysts, 48 cases of severe salpingitis, 33 ectopic pregnancies, 35 cases of adhesiolysis for pelvic pain, and 43 cases with diverse indications. 5. We did not experience any serious hemorrhage or infection in the immediate postoperative period. 6. The average length of hospitalization was 3 days.
4. Discussion The experience at Yaounde ´ has allowed precise evaluation of the advantages resulting from the use of laparoscopic surgery in gynecology in an African country } notably the reduced risk of peri-operative infection and the reduction in postoperative adhesions. The training of the surgical team is the most vital condition for the success of such a project in other hospitals in central Africa. The training of just the surgeon is not sufficient, a competent anesthetist and well-trained theater staff are indispensable. The laparoscopic surgery center at the Yaounde ´ General Hospital has offered to organize training courses for African surgeons. References w1x Raiga J, Kasia JM, Canis M, Glowazzower E, Doh AS, Bruhat MA. Special communication: Introduction of gynecologic endoscopic surgery in an African Setting. Int J Gynecol Obstet 1994;46:261. w2x Kasia JM, Raiga J, Doh AS et al. Laparoscopic fimbrioplasty and neosalpingostomy. Exerience of the Yaounde ´ General Hospital, Cameroon Žreport of the 194 cases.. Eur J Obstet Gynecol Reprod Biol 1997;73:71.
Brief communication
Laparoscopic surgery in the Cameroon J. Raigaa,U , J.M. Kasiab, M.A. Bruhat c a Department of Obstetrics and Gynecology, Hopital Ci¨ il, Strasbourg, France ˆ Department of Obstetrics and Gynecology, Hopital General ˆ ´ ´ de Yaounde, ´ Yaounde, ´ Cameroon c Department of Obstetrics and Gynecology Reproducti¨ e Medicine, Clermont Ferrand, France
b
Received 21 April 1998; received in revised form 15 September 1998; accepted 23 September 1998
Abstract A new surgical section of operative laparoscopy was installed in General Hospital of Yaounde, ´ Cameroon, in April 1992 after many years of collaboration between the University of Clermont]Ferrand and the University of Yaounde. ´ A total of 735 laparoscopic operations were conducted in the first 5 years. Conditions facilitating such a project are discussed. Q 1999 International Federation of Gynecology and Obstetrics. Keywords: Gynecology; Laparoscopy; Sterility; Cameroon; Africa
1. Introduction A laporoscopic surgery unit was created in 1992 as part of the Gynecology Department at the Yaounde ´ General Hospital, Cameroon. The installation of this unit was the result of close collaboration between the University of Yaounde ´ and that of Clermont]Ferrand, France w1x. The unit has been open since 1992 and has carried out 735 operations laporoscopically. This experience leads us to reflect on the use of this technique in an African country and on the necessary conditions for such an installation.
2. Materials and methods The laporoscopic surgery unit was created in 1992 within the Gynecology Department of the Yaounde ´ General Hospital, Cameroon. v
v
U
Corresponding author.
The surgical team consisted of a Cameroonian Gynecologist who had trained for 7 years in laparoscopic surgery under Prof. Bruhat in the department of gynecology at Clermont]Ferrand. The anesthetists and theater staff had all benefited from several months training in the same department. The laparoscopy equipment: a complete column was kindly funded by Storz.
0020-7292r99r$20.00 Q 1999 International Federation of Gynecology and Obstetrics. PII: S 0 0 2 0 - 7 2 9 2 Ž 9 8 . 0 0 2 0 6 - 9
J. Raiga et al. r International Journal of Gynecology & Obstetrics 65 (1999) 65]66
66 v
The cost to the patient of a laparoscopic operation was worked out as 100 000 francs CFA, or US$ 200. This included the price of the operation plus average hospital stay of 3 days.
3. Results
1. A total of 735 laparoscopic operations were carried out between the 1 May 1992 and 1 May 1996. 2. Sterility remains the most frequent indication: 497 cases Ž67.6%.. 3. The laparoscopic findings were marked by the frequency of pelvic adhesions. A study of the first 194 patients operated on showed encouraging results 2 years later w2x: 45 intra-uterine pregnancies Ž23.2%. and 8 ectopic pregnancies Ž4.1%.. 4. Other indications representing 238 cases Ž32.4%. included 79 ovarian cysts, 48 cases of severe salpingitis, 33 ectopic pregnancies, 35 cases of adhesiolysis for pelvic pain, and 43 cases with diverse indications. 5. We did not experience any serious hemorrhage or infection in the immediate postoperative period. 6. The average length of hospitalization was 3 days.
4. Discussion The experience at Yaounde ´ has allowed precise evaluation of the advantages resulting from the use of laparoscopic surgery in gynecology in an African country } notably the reduced risk of peri-operative infection and the reduction in postoperative adhesions. The training of the surgical team is the most vital condition for the success of such a project in other hospitals in central Africa. The training of just the surgeon is not sufficient, a competent anesthetist and well-trained theater staff are indispensable. The laparoscopic surgery center at the Yaounde ´ General Hospital has offered to organize training courses for African surgeons. References w1x Raiga J, Kasia JM, Canis M, Glowazzower E, Doh AS, Bruhat MA. Special communication: Introduction of gynecologic endoscopic surgery in an African Setting. Int J Gynecol Obstet 1994;46:261. w2x Kasia JM, Raiga J, Doh AS et al. Laparoscopic fimbrioplasty and neosalpingostomy. Exerience of the Yaounde ´ General Hospital, Cameroon Žreport of the 194 cases.. Eur J Obstet Gynecol Reprod Biol 1997;73:71.