THE PRACTICE OF MINIMAL ACCESS SURGERY IN NIGERIA. CHALLENGES AND PROSPECT

BACKGROUND: There is increasing enthusiasm in the acquisition of skills in minimal access surgery MAS in Nigeria. OBJECTIVES: This study was therefore conducted to assess the extent of practice of MAS in 25 Federal and State Teaching Hospitals TH and 22 Federal Medical Centres FMC in Nigeria, the challenges faced and the prospect for it. METHODS: This was a prospective descriptive longitudinal study. A stepwise multistage cluster sampling technique was adopted whereby questionnaires were distributed to consultant delegates at the November 2015 SOGON Conference in Abuja and at the Benin Fetal Medicine Workshop in 2016. Data was analysed using the statistical package SPSS- 20. RESULTS: The differences between the number of tertiary institutions that perform and those that do not perform diagnostic hysteroscopy was not statistically significant but it was statistically significant for diagnostic laparoscopy and dye test with more hospitals doing them (p = 0.001). Fewer institutions perform resection of endometrial polyps, endometrium, submucous fibroids, endometrial synechiae and septum, abdominal adhesiolysis, Salpingectomy, oophorectomy, cystectomy, myomectomy and hysterectomy (P = 0.001- 0.07 and 0.02-0.001 in FMC and TH respectively) with most of the differences been statistically significant. Endometrial ablation, incontinence and other major MAS were not performed in Nigerian tertiary centres. CONCLUSION: MAS has been partially introduced in Nigerian tertiary health institutions but there are enormous challenges to its expansion.