Laparoscopic Surgical Exposure and Training among Resident Doctors: A Cross-Sectional Multicenter Study in Southwest Nigeria.

Abstract

Background: Laparoscopy is underutilized in underdeveloped countries. The residency program provides a good opportunity to introduce laparoscopy to gynecology trainees. This study aimed to evaluate residents' exposure and education on laparoscopic training in gynecology across different centers in Southwest Nigeria. Methodology: This study was carried out among 75 resident doctors in gynecology across four centers in Southwest Nigeria. Data was collected using a modified pretested semi-structured questionnaire. Continuous and categorical variables were summarized, and the Chi-square test was used to test for statistical associations at p<0.05. Results: The study found that two-thirds of the respondents had attended a local training program in laparoscopy, and 81.3% of the residents had an above-average level of knowledge. The level of knowledge of laparoscopy was significantly associated with the cadre of the residents, center, and the level of exposure of the residents to laparoscopy (χ2 = 7.040, p= 0.008; χ2 = 19.233, p= 0.001; χ2 = 28.440, p= 0.001). While laparoscopy facilities were available in almost all centers, the average monthly laparoscopy procedure was 2.40±1.25. Only about half of the doctors have assisted in laparoscopic procedures, and just 4.0% have performed a laparoscopic procedure under supervision. Exposure to laparoscopy was associated with the cadre, center, the average number of laparoscopies performed per month in the center, availability of training programs for laparoscopy and the availability of skills lab (χ2 = 10.215, p= 0.001; χ2 = 25.182, p= 0.001; χ2 = 15.444, p= 0.001; χ2 = 35.810, p= 0.001; χ2 = 8.214, p= 0.004). Factors limiting exposure and expertise included lack of funds, low surgeon motivation, lack of trained personnel, and institutional support. Conclusion: The study indicates high knowledge and exposure to laparoscopy among Southwest Nigerian doctors, but low competence, emphasizing the need for further inclusion in Nigeria's postgraduate training programs.