Surgical Complication Rates and Risk Factors in Gynaecological Laparoscopic Procedures at Nigerian Teaching Hospitals

Laparoscopic gynaecological surgery offers significant patient benefits over open surgery, but its safety profile in Nigerian teaching hospitals, where equipment maintenance, training capacity, and patient selection are variable, has not been empirically characterised. This study determines the surgical complication rates and associated risk factors in gynaecological laparoscopic procedures at teaching hospitals in Lagos, Abuja, and Ibadan. A retrospective multi-site cohort study reviewed records of 280 consecutive laparoscopic procedures over three years. Data on procedure type, operative time, conversion to laparotomy, intraoperative and postoperative complications, and surgeon experience level were extracted. Overall complication rate was 14.3 percent. Conversion to laparotomy occurred in 8.9 percent. Intraoperative complications included bowel injury (2.1 percent) and visceral vessel injury (1.4 percent). Postoperative complications were dominated by port-site infections (4.6 percent) and prolonged ileus (3.2 percent). Surgeon case volume below 50 laparoscopic procedures (OR 3.7), BMI above 35 kg/m2 (OR 2.9), and prior midline laparotomy (OR 2.4) were significant complication predictors. The study demonstrates an acceptable but improvable complication profile and highlights surgeon experience as the dominant modifiable risk factor. Recommendations include structured laparoscopic mentorship programmes, minimum case volume credentialing requirements, and patient selection criteria standardisation across Nigerian teaching hospitals offering laparoscopic services. Keywords: laparoscopic surgery, complications, gynaecology, Nigeria, surgical outcomes