The Practice of Pediatric Laparoscopic Surgery in Rural Cameroon, A Retrospective Review.

Background Laparoscopy equipment is now more readily available in sub-Saharan Africa than previously reported. However, little is known about its uptake and outcomes, especially in the pediatric age group. We aimed to present our experience with pediatric laparoscopy in a limited-resource setting. Method This retrospective review of operating room, inpatient, and electronic medical records at Mbingo Baptist Hospital, Cameroon (January 2018 - December 2024), involved all pediatric laparoscopic cases. The analysed data included demographics, indications, procedures, surgery time, intraoperative and postoperative complications, conversion rates, hospital stay days, and costs. Results A total of 167 laparoscopic cases were performed during the study period. This included 74.9% males and 25.1% females with ages ranging from 6 weeks to 20 years and a mean age of 5.5 years ± 5.3 SD. The most common indications for laparoscopy were cryptorchidism (28.1%), Hirschsprung’s disease (18.6%), appendicitis and its complications (7.8%), and pyloric stenosis (5.9%). 74.9% of cases were therapeutic, while 25.1% were diagnostic, with a conversion rate of 13.7%. 4.8% of patients sustained intraoperative complications, while 11.4% of patients developed post-op complications. The mean surgery time was 97.2 minutes ± 62.6 SD. The patients who developed postoperative complications were most likely to be in surgery for > 120 minutes, P=0.001. The median hospital stay was 3 days. The surgery fees ranged from 256.6 to 2,052.4 I$PPP, while the cost of hospitalization ranged from 494.8 to 5,497.8 I$PPP. Post Op complications resulted in longer hospital stays (P<0.001) and increased cost (P<0.001) Conclusion: The scope of laparoscopic surgery was broad, and the outcomes and cost were comparable to those reported in the region.