COMPLICATIONS OF LAPRASCOPIC SURGERY IN WAD MEDANI TEACHING HOSPITAL - GEZIRA STATE (JAN 2009-DEC 2010).

This is a prospective hospital based clinical study conducted at Wad Medani Teaching Hospital during the period (Jan2009 to Jan2010), which included patients who underwent laparoscopic surgery. A total of 113 patients were studied. Seventeen patients (15%) were males, 96 patients (85%) were females. Fifty two (46.1%) of the patients age were (40-59)years. The majority of the studied population was from Wad Medani locality, they accounted for forty one (36.3%) patients. The length of the hospital stay in one hundred and five (92.9%) patients was less than 2 days. Indications for laparoscopic surgery was cholecystectomy of Gall Bladder Disease in one hundred and ten (97.3%) patients, high ligation of varicose veins in one (0.9%) patient and diagnostic laparoscopy in two(1.8%) patients. The conversion rate of laparoscopic operations to open operations was three patients (2.7%). The reasons for conversion from laparoscopic to open surgery varied from bleeding; one (0.9%) patient to difficult procedure in two (1.8%) patients. There were no other reasons for conversion in the studied population. III The studied population has been followed up postoperatively for complication. The complications were infection (peritonitis due to biliary leakage) in one (0.9) patient, umbilical port hernia one (0.9) patient and death in One (0.9) patient. The total number of laparoscopic surgeries complications in the studied population was six patients (5.4%). In this study only one death was reported. The conclusions of the study were: 1. Laparoscopic surgeries were feasible and cost effective in Sudan. 2. Laparoscopic surgeries could be performed safely in the majority of patients, by an experienced surgical team. 3. Laparoscopic surgeries were an effective way to treat patients and were worthy to be recommended because of its advantages of less interferences, few complications, and quick recovery. 4. Laparoscopic surgery has lesser morbidity rate. 5. The incidence of organ injury in laparoscopic surgery is 0.9%. 6. Laparoscopic surgeries were a safe method of treatment with very low conversion rate. 7. Although procedure times are shorter, hospital stay is less, which leads to a faster return to work. 8. less post operative discomfort since they are much smaller incisions IV The study recommended that: 1. More training to surgeons, and staff. 2. Increase the capacity of the department; more Laparoscopic rooms, and more staff. 3. Laparoscopic surgeries should be performed for emergency conditions such as appendisectomy, elective conditions such as hernias. 4. To train registrars to perform Laparoscopic surgeries. 5. To do more surgical operations through laparoscopic surgery procedures. 6. To train the trainees how to perform open surgeries so as to deal with complications of laparoscopic surgeries (in cases of conversions). 7. Since laparoscopic surgery has a high diagnostic yield and is a cost-effective technique it should be recommended for use in developing countries. 8. The awareness of the population for laparoscopic surgery should be increased.