Laparoscopic Activity in Pediatric Surgery Senegal; bicentric study

Abstract

Introduction: Pediatric laparoscopy is a minimally invasive technique offering significant advantages. In Senegal, its adoption is limited by material and training constraints. This bicenter study describes and compares the first pediatric laparoscopic activities of two Senegalese university hospitals. Methods: A prospective descriptive study was conducted over periods of 17 months (Thiès Regional Hospital Center, HRT) and 35 months (Dakar Main Hospital, HPD). All children who underwent laparoscopic surgery were included. The parameters analyzed included epidemiological characteristics, indications, surgical techniques, and peri- and postoperative outcomes. Results: A total of 101 patients were included (51 at HRT, 50 at HPD). Laparoscopic activity accounted for 13.42% of procedures at HRT and 7.59% at HPD. The main indications were appendicitis (45% HRT, 10% HPD), cryptorchidism (22% HRT, 26% HPD), and gallstones (20% HRT, 30% HPD). The “open laparoscopy” approach was used systematically. The conversion rate was low (2.1% at HRT, 2% at HPD), but the rate of intraoperative incidents was higher at HRT (18.7% vs. 4%). Postoperative morbidity was 2% (HRT) and 6% (HPD), with one death at HRT. The average length of hospital stay was 7 days at HRT versus 1.8 days at HPD. Conclusion: This study demonstrates the feasibility and safety of pediatric laparoscopy in Senegal for common indications. It reveals disparities between centers related to recruitment, local expertise, and integration of the activity. Optimizing this practice requires strengthening specialized training, increasing access to appropriate equipment, and better integration into the daily and emergency surgical care of children.