Introduction: laparoscopy has become the gold standard for many surgical cases in the developed world. It however, remains a rarity in developing countries for several reasons, a major one being cost. This study aimed to determine the knowledge and attitude of patients attending Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana toward laparoscopic surgery and their willingness to pay for it.

Methods: a cross-sectional survey was conducted among patients attending specialist clinics at KATH.

Results: 1070 patients participated. Mean age was 40±15years. 54% were city-dwellers. 14% had salary-paying jobs. None had undergone prior laparoscopic surgery. 3% had knowledge of laparoscopy. 95% preferred laparoscopy to open surgery mainly because of faster recovery and less post-op pain. Age >45years (AOR=0.53,p=0.03) and higher education (AOR=2.00,p=0.04) were significant predictors of patient choice. Among those preferring laparoscopy, 78% were willing to pay more than the baseline cost of open surgery for laparoscopy. A history of previous abdominal surgery (AOR=0.67,p=0.02), having a salaried job compared with being unemployed (AOR=2.36,p<0.01) and living in the city compared with the village (AOR=1.78,p=0.04) were significant predictors of patients' willingness to pay more for laparoscopy.

Conclusion: knowledge about laparoscopy and its benefits are severely lacking among patients at KATH. Once educated about its benefits, most people prefer laparoscopy even if they needed to pay more for it even in resource-limited countries like Ghana.