RESIDENT-LED ADOPTION OF ROUTINE LAPAROSCOPIC APPENDECTOMY IN A NIGERIAN TEACHING HOSPITAL  adedayolawal91@gmail.com

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RESIDENT-LED ADOPTION OF ROUTINE LAPAROSCOPIC APPENDECTOMY IN A NIGERIAN TEACHING HOSPITAL 

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Nigeria

Oral only

Appendectomy is one of the most common emergency procedures and often the first major operation performed by surgical residents. While laparoscopic appendectomy offers several advantages, the open technique remains predominant in resource-limited settings like Nigeria due to infrastructure and training gaps. The study aimed to document a resident-driven shift from open to routine laparoscopic appendectomy at a Nigerian teaching hospital.

A retrospective review of appendectomies performed at the Ife Hospital Unit, Obafemi Awolowo University Teaching Hospitals Complex between January 2019 and April 2025. Cases were grouped into two periods: pre- and post-October 2023, when resident-led laparoscopic appendectomy was introduced. Data on patient demographics, surgical approach, surgeon cadre, complications, and operative time were analyzed.

265 patients for appendectomy were reviewed in the study period. Between January 2019 and September 2023, 189 appendectomies were performed, with 76.7% done via open surgery. All 44 laparoscopic cases (23.3%) were performed by consultants. After October 2023, 76 appendectomies were done by residents, 89.4% of which were laparoscopic. Three conversions to open were required. Postoperative complications occurred in 2 (2.9%) patients: one re-operation for localized peritonitis and one pelvic collection managed conservatively. Mean operative time for laparoscopic cases improved significantly, decreasing from 110 to 60 minutes over time.

This study demonstrates a successful resident-led transition toward routine laparoscopic appendectomy. With continued exposure and skill development, minimally invasive surgery can become routine even in resource-limited settings. Integrating structured laparoscopic training into residency programs is essential for sustaining this progress