Mulago unveils cancer surgery using camera

During a laparoscopic surgery for cancer and other diseases, only one or more small incisions (around 1centimetre) are made in the abdomen by a surgeon as they are guided by a video monitor using the camera inserted into the body through the mouth or other opening.
“Someone who is operated [using this new method] recovers very fast [from the small incisions], it is also cosmetic because there is no scar left and also the persons spend less time in hospital [to recover from minor incisions],” Dr John Sekabira, the acting hospital deputy director, said yesterday. He was addressing journalists at the handover of the Laparoscopy simulation centre in the hospital where doctors and surgeons, who have been doing open surgery, will be trained on specially designed dummies before they can practice laparoscopy on humans.

Dr Norbert Orwotho, the head of surgeons at the facility, said the centre will build the capacity of doctors at Mulago and other hospitals in the country to handle the increasing demand for laparoscopic surgery.
The centre was established with financial support from the Korea International Cooperation Agency (KOICA). 
The agency has since 2019 been supporting the hospital to develop the capacity to conduct laparoscopy and endoscopy –another procedure used to examine the stomach and intestine for diagnostic purposes. 

But the success has been limited because they didn’t have basic training before practising on humans, according to the KOICA.
Dr Hyukjun Chung from the KOICA, who has been working in Mulago for six years, said they have so far handled more than 2,000 cases.  
“We are handing over the most active and reliable centre in Uganda. But during this period, I saw limitations among doctors when dealing with real human patients. So there was a limitation to educating and letting them do. So, we decided to establish the KOICA Mulago minimally invasive surgery centre,”  Dr Chung said.

He added: “When we have a dummy, we don’t have limitation to train doctors or postgraduate students. It is a good step to start this type of surgery efficiently,” the KOICA country cirector, Mr Taeyoung Kim, said the newly established simulation centre cost $50,000 (Shs188m) to establish and that they have been supporting the hospital in different ways.
Dr Orwotho said they have four laparoscopy towers, with the special equipment for the surgical procedure costs, each costing $270,000 (Shs1b).
“The trend is now moving towards pinhole (laparoscopic surgery), patients are now requiring lesser scars, smaller incisions and few days in hospitals and quicker recovery. So if we can have more towers, we shall be having more surgeries,” he said.

Around 36 patients are operated on monthly at hospital using this method, according to Dr Joseph Jjombwe, another expert at the centre. 
“As Mulago, we already doing this. The surgeons are there but the equipment are few. The surgeries include those to do with the intestines, on the liver, pancreas, appendicitis, cancer of the stomach, liver and we also do diagnosis using the equipment,”  Dr Jjombwe said.  

Cost of surgery

Dr Joseph Jjombwe said a patient getting surgery may be requested to provided unspecified requirements which cost between Shs500,000 to Shs1m.  He said if there is no waiver, patients, especially in a private hospital setting, may have to pay between Shs3m and Shs7m for laparoscopic surgery.