Medical Tourism: How Weekly Robotic Surgery in Lagos is Saving Nigeria $20,000 Per Patient

What was meant to mark one year of robotic surgery turned into a larger story: a human audit of Nigeria’s medical tourism burden and how it is being solved at home, one scarless operation at a time. With prostate cancer still the most common cancer in Nigerian men and thousands spending $15,000 to $20,000 abroad for treatment, a Lagos hospital’s weekly robotic surgery programme is proving that lives once turned away elsewhere can now be saved here, while keeping millions in foreign exchange within the country. Writes MARY NNAH

Joseph Adie Ogar was in his 40s in 2012, working at the National Assembly, when he began waking up to urinate frequently. He went to the clinic at the Assembly, was referred to a hospital in Asokoro, then, on his sister’s advice, to National Hospital. The doctor was surprised at his age. He asked him to repeat the tests. They confirmed it: prostate cancer.

The treatment was surgery. The warning around him was different – that after such surgery, he would lose his sexual function. Fear around prostate surgery in Nigeria often outlives the cancer itself.

Ogar became Nigeria’s first Laparoscopic Radical Prostatectomy in 2012. The operation was performed at Kelina Hospital during a training visit by Dr. Mahesh Desai, then President of Société Internationale d’Urologie, who came because Kelina had the equipment no other hospital had. All urologists in Nigeria were invited for the training. Only 14 came.

Fourteen years later, Ogar sat in a press conference in Lagos on October 10, 2026, called to mark one year of robotic surgery. He sat healthy, without medication for the condition since 2012, without radiotherapy or chemotherapy, going only for regular PSA checks – his last about 5.0 and with his family life intact.

“I am alive, I have a wife, and I am grateful that I can continue to enjoy my life with her,” he said.

He still remembers the fear that nearly stopped him. “I told the doctor I would rather die than lose my sexual life,” he confessed, but the doctor reassured him, operated, and kept calling after the operation until Ogar told him he was completely fine. That fear is why medical tourism thrives. That survival is why it does not have to.

The press conference had the full leadership of Kelina: President, Dr. Celsus Ukelina Undie; Chairman of the Board, Dr. Ifeanyi Anago; board members; Chief Medical Director for Abuja, Dr. Kelechi Nedosa; Chief Medical Director for Lagos, Dr. Ibukun Adeyinka; consultants; management and staff.

October is Cancer Awareness Month, and prostate cancer is the most common cancer affecting men in Nigeria. Undie said the day was to review one year of robotics, thank patients who trusted them – many young people who returned to healthy lives without physical limitations and thank God for helping them this far.

The numbers behind the thanks were presented by Dr. Undie and by Dr. Doose Doo, Company Secretary and Head of Corporate Governance.

Kelina has now performed more than 7,000 surgeries, approaching 8,000. The caseload includes diabetic patients, patients in heart failure and kidney failure, patients who came on stretchers and in wheelchairs, and patients rejected elsewhere.

For 15 years, it recorded no deaths in its operating theatre, keeping mortality at 0.0007 percent. That record was broken only after 15 years.

In 2025 alone, 212 prostate surgeries using robotic, Holmium Laser Enucleation of the Prostate (HoLEP, and laparoscopic techniques – the highest volume in Nigeria.

Over 800 HoLEP surgeries in eight years, meaning over 100 per year, because Nigerians have chosen it over TURP. Only laser and open surgery can take out prostates of any size, but HoLEP has no wound on the skin, no scar, less bleeding, lower transfusion rate, less pain, shorter admission, and easier return to work.

According to American Urological Association and European Association of Urology guidelines, TURP should be limited to prostates smaller than 100g. HoLEP has no size limitation.

Since September 2025, over 50 robotic radical prostatectomies. Kelina is the first hospital in Africa to acquire the EDGE MP1000 surgical robot and the first completely Nigerian-based team doing Robot-Assisted Radical Prostatectomy regularly since June 2026.

It is today the only hospital in Nigeria doing robotic surgery every week. Two were done last week. One done two days before the briefing was already on his feet in the ward, eating without restriction, waiting for discharge, exercising vigorously until staff had to advise him to slow down.

Since June 2026, no robotic prostate cancer patient has required blood transfusion. One patient came with packed cell volume of 49 percent and left the theatre at 43 percent.

More than 50 percent of urology patients are discharged within 24 hours.

These efficiencies are the economic argument against medical tourism, and the second patient in the room illustrates it.

Temilola Oke first came to Kelina around 2014 or 2015. At that time, Kelina operated only in Abuja. She travelled from Lagos to Abuja for large kidney stones and had a procedure. Afterward, doctors found a congenital abnormality, an obstruction preventing urine from draining properly from her kidney, present from birth, that would permanently damage the kidney if not corrected. Previously, correction meant open surgery and a large abdominal scar. She was told in 2015. She refused.

“I was reluctant to undergo the operation because I thought it would leave me with a large scar on my abdomen,” she said.

In 2018, she returned and became Nigeria’s first Laparoscopic Pyeloplasty. She takes no medication for it today, only unrelated supplements, and she is well.

Kelina said she was one reason management decided to come to Lagos, as several patients were coming to Abuja from Lagos for minimally invasive surgery.

The third story, narrated by Dr. Adeyinka, is the starkest. A man arrived with a urinary bladder filled with blood clots, in kidney failure and on dialysis, in heart failure with an ejection fraction of about 30 percent, dependent on oxygen, and bleeding severely. For 15 years he needed surgery, and other hospitals rejected him as unfit.”

His relatives in America advised him to come to Kelina,” Adeyinka said. “When he arrived, we knew that without surgery, he would likely die. Although the procedure carried significant risks, it offered him a chance of survival.

“The team worked him up carefully and performed emergency HoLEP between 1 a.m. and 5 a.m.” He survived and is alive today, living a healthy life and completely free from kidney failure,” Adeyinka said.

These are not patients who could have flown abroad for $15,000 to $20,000. They are patients who would have died at home if the capacity did not exist at home.

Dr. Nedosa presented another first that defines the issue. A patient had kidney cancer. One kidney was removed for cancer in India about 10 years earlier. The remaining kidney – a solitary kidney – later developed cancer. If removed, he would need dialysis two or three times a week for life or a transplant, but transplant patients need immunosuppression to prevent rejection, and immunosuppression suppresses the body from fighting cancer, so cancer patients do not do well with transplantation.

“The only chance he had was a partial nephrectomy. In other words, nearly half of the remaining kidney would have to be taken out, along with the cancer, for him to continue to live. That was exactly what we did,” Undie explained.

Kelina performed Nigeria’s first Laparoscopic Partial Nephrectomy in a solitary kidney in 2025. The patient is alive today, not on dialysis, with only a quarter of the overall kidney volume he was given by God.

In 2025, Kelina also performed what it records as Nigeria’s first Robotic Radical Nephrectomy on a medical doctor who had kidney cancer and did not want any other method apart from robotic surgery.

Dr. Nedosa placed these in a chain of Nigerian firsts that built local capacity to stop travel: First PCNL in Nigeria in 2011, a minimally invasive procedure for large kidney stones where other methods fail apart from open surgery. To do it, Kelina acquired special equipment including ultrasonic, pneumatic, and laser lithotripsy machines and the Swiss Lithoclast Master, the first ever in Nigeria, which breaks stones and sucks particles at the same time – probably the best machine ever made for huge stones. Since 2011, kidney stones of all sizes and locations, and bladder stones, have been treated here.

For Kelina Hospital, the list of Nigerian firsts is long, and each was presented with dates: First laser lithotripsy for kidney stones by a purely Nigerian team in February 2012, after the first laser was acquired by a private hospital in 2010. Foreign specialists initially assisted with training, but the Nigerian team developed expertise independently to perform it alone. First Transurethral Bipolar Enucleation of the Prostate in 2012 during Desai’s visit. First tubeless supracostal PCNL in 2013, a more difficult method done without nephrostomy tubes, going above the ribs and risking lung or pleura damage, with results presented at the Nigerian Association of Urological Surgeons AGM in Ibadan.

First Mini-PCNL in 2013 utilising very tiny instruments that leave little or no mark; for stones, flexible endoscopy cannot reach where standard PCNL is not necessary, also presented in Ibadan. First Laparoscopic Radical Prostatectomy in 2012 – Ogar’s case. First Laparoscopic Pyeloplasty in 2018 – Temilola’s case.

First HoLEP in 2018 after sending a urologist to Europe for training due to patient demand. Now, first robotic cases in 2025 and a weekly robotic programme from June 2026.

Undie, answering questions on why mark one year and whether robotics can replace conventional surgery, said robotics is actually easier than laparoscopic in many respects, and laparoscopic is less invasive than open. Many surgeons have practiced for over 35 years when most procedures were open because technology and equipment were not available. Patients began asking for minimally invasive procedures unavailable locally, forcing many to travel abroad. Their needs challenged Kelina to develop services.

“Robotic surgery has several advantages, although the equipment is expensive, the required skills are not widely available, and the training can be demanding. Once the necessary skills are acquired, however, the procedures can be easier to perform than some other surgical methods,” he said.

The patient two days before ate the same day and moved the next day. Robotic surgery offers three-dimensional vision, improved precision, and instruments that minimize hand tremor. But no surgical method is perfect. Kidney stones need a laser or PCNL. Kelina uses several techniques – endoscopic, laparoscopic, laser, robotic — depending on condition. Robotic is particularly useful for prostate cancer.

Dr. Obiwuru clarified volumes: most common is HoLEP, then prostate cancer and kidney stone surgery, plus gallstones, general surgery, and gynaecological surgery. Urology remains the heart of operations because most senior surgeons are urologists.

Total over 7,000, approaching 8,000, with some losses over 18 years but none in theatre for the first 15 years.

On foreign exchange, he gave the reference that now defines the headline: where he trained abroad, treatment cost $15,000 to $20,000 per patient. Using that figure, savings can be estimated, though the actual amount depends on procedure, hospital, and travel. At $15,000, 7,000 patients is $105 million. At $20,000, $140 million – before flights, visas, and hotels.

Kelina has received Federal Government recognition for curbing medical tourism: Pioneer Status in Minimally Invasive Surgery in 2012 from the Nigerian Investment Promotion Council and Federal Ministry of Industry, Trade and Investment – first hospital in Nigeria to receive it – plus support through the Ministry of Finance with concessions and discounts on the import of specialised equipment not readily available elsewhere.

It operates in Abuja and Lagos with eight specialties: Urology with 4 consultants, Obstetrics and Gynaecology with 3, ENT with 4, Cardiology with 2, Nephrology with 2 with brand new dialysis machines and doubly purified water, Family Medicine with 2, Paediatrics with 2, General Surgery with 2. Yet two issues remain: training and affordability.

On training, Undie said a professor who trained him contacted him weeks ago, suggesting a formal training program at Kelina with accreditation. Previously reluctant because surgical training can damage equipment costing N20m to N30m per instrument, but visiting urologists already train – one from another country trained for a year before returning home, another expected before the end of October, another next month- with a national programme planned early next year to ensure expertise spreads rather than remains concentrated.

On helping those who cannot afford surgery and partnership with the government, Undie returned to cancer’s reality.

“Cancer surgery, particularly prostate cancer surgery, is a matter of life and death. Nobody has a relative or children in the grave,” he said.

“If a woman needs to have her breast removed because of cancer, she cannot refuse… If a woman needs to have her uterus removed because of cancer, she cannot put the desire to have more children ahead of saving her life. When a man needs prostate cancer surgery to survive, the first priority is not an erection. That concern can be addressed after… Many patients recover their erectile function naturally, as the patient who spoke earlier explained. Others may require medication, injections or even penile implants. We have medication. With an injection of just 0.3 millilitres, a patient may be able to achieve an erection… Saving the patient’s life comes first; other concerns can be addressed afterwards.”

He has had patients in China who received surgery completely free, collaborates with NGOs that sponsor surgery, but private hospitals cannot do 1,000 free surgeries without closing because salaries must be paid and equipment replaced.

“Thousands, if not millions, of Nigerians need assistance… We therefore need your help in reaching people and institutions that can provide support… Healthcare should receive similar attention… Why has India become a major destination for medical tourism?

“Government support, including access to loans at lower interest rates, has helped its healthcare sector grow. I recently spoke with someone who said loans were available at four per cent interest, compared with the much higher rates charged by Nigerian banks.

“We need similar support because one hospital cannot solve the healthcare problems of the entire country. We are not asking for free money or support for Kelina Hospital alone. We are asking for support for hospitals across Nigeria. Private hospitals are driving a significant part of healthcare delivery in the country, and they need assistance to acquire modern technology and improve services. With the right support, more advanced medical procedures can be performed locally, helping to reduce the amount of money Nigerians spend on treatment abroad.”

That is the full meaning of weekly robotic surgery in Lagos. It is not just a robot that allows eating the same day, walking the next day, discharge within 24 hours, and blood loss from 49 percent to 43 percent.

It is a man in his 40s who refused to accept that cancer surgery meant losing manhood and kept it for 14 years, a woman who feared a scar and kept her kidney, a man with one kidney left who kept a quarter of it and stayed off dialysis, and a man on dialysis and oxygen rejected for 15 years who now lives free of kidney failure – all operated at home. When that happens every week, Nigeria saves not only $20,000 per patient, but the life that would have been lost trying to find it.