The Kilimanjaro Christian Medical Centre – Northumbria Healthcare Link, a Roadmap for Global Laparoscopic Surgery

ABSTRACT NUMBER: NESTAC_02

AUTHORS
Miss Bronwyn Woodburn, Miss Oroog Ali, Miss Imogen Cullen, Mr Ryan Ghita, Mr Alastair Hayes, Mr Duncan Light, Miss Kirsty McVey, Mr Fadlo Shaban, Dr Kondo Chilonga, Mr Liam Horgan

AFFILIATIONS
• Bronwyn Woodburn and Imogen Cullen: Newcastle University, Newcastle, U.K.
• Oroog Ali, Alastair Hayes, Duncan Light, Kirsty McVey, Fadlo Shaban, Liam Horgan: Northumbria Healthcare NHS Foundation Trust, U.K.
• Ryan Ghita: Queen Elizabeth University Hospital, Glasgow,UK
• Kondo Chilonga: Kilimanjaro Christian Medical Centre, Moshi, Tanzania

CORRESPONDING AUTHOR CONTACT EMAIL
Dr. Kondo Chilonga: moc.oohay@agnolihck
Mr. Liam Horgan: ofni.snagroh@mail

 

MAIN ABSTRACT TEXT

Introduction
Since 2004 surgeons from Northumbria Healthcare Trust (NHCT) have trained Tanzanian surgeons at Kilimanjaro Christian Medical Centre (KCMC) how to perform various laparoscopic procedures. This project’s aim was to audit the outcomes of the 889 operations performed, and assess the factors that led to the success of this project.

Methods
Theatre logbook data at KCMC was used to identify all the laparoscopic operations since 2015. The patients’ medical records were then examined and data collected on demographics, diagnostic criteria, surgical details and outcomes at a minimum of one month follow-up. This data was then combined with a previously validated database from 2005-2014. Outcomes studied included conversion and complication rates.

Results
512 cases were identified from 2015-2019, bringing the total to 889 laparoscopic procedures. In 2005, 12 laparoscopic cholecystectomies (LCs) and 2 laparoscopic appendicectomies (LAs) were performed. Of these, 4 LCs were converted, giving a conversion rate of 33.33% for LCs, and 28.57% overall. In comparison, with the data gathered so far, in 2018 there were 5 diagnostic laparoscopies (DLs), 14 LAs with 1 conversion (7.14%), 98 LCs with 1 conversion (1.02%) giving an overall conversion rate of 1.71%. This research is still ongoing.

Conclusions
Throughout 14 years of laparoscopic surgery at KCMC, the conversion rate has decreased to levels lower than those previously reported by NHCT, putting them on par with other first world countries. Not only has this partnership brought Tanzanian surgery into the 21st century, it has also been sustainable, and an example for other global surgery partnerships to follow.