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Outpatient laparoscopic surgery: feasibility and consequences for education and health care costs

Abstract

Background

The purpose of this paper is to describe the outcome of ambulatory laparoscopic cholecystectomy (LC), antireflux surgery, adrenalectomy and splenectomy and possible implications for surgical education and health care costs.

Methods

Prospective, observational study 1994–2003.

Results

The success rate of ambulatory treatment was 83.5% in 1060 LC patients, 80% in 113 antireflux procedures, 100% in 22 laparoscopic adrenalectomies, and 75% in 12 laparoscopic splenectomies. In a total number of 1207 patients, health care costs were reduced by almost $700,000, compared to 1-day hospital stay. The educational potential of same-day surgery is large, due to high numbers of patients, and 80% of our educational potential has been exploited.

Conclusion

Ambulatory laparoscopic surgery is cost effective, patient friendly, and appropriate for surgical resident training. Strict organization of security rules is mandatory.

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References

  1. 1.

    RE Burney KR Jones (2002) ArticleTitleAmbulatory and admitted laparoscopic cholecystectomy patients have comparable outcomes but different functional health status. Surg Endosc 16 921–926 Occurrence Handle10.1007/s00464-001-8201-z Occurrence Handle1:STN:280:DC%2BD38vgvFGntQ%3D%3D Occurrence Handle12163955

  2. 2.

    JF Calland K Tanaka E Foley VE Bovbjerg DW Markey S Blome JS Minasi JB Hanks MM Moore JS Young RS Jones BD Schirmer RB Adams (2001) ArticleTitleOutpatient laparoscopic cholecystectomy: patient outcomes after implementation of a clinical pathway. Ann Surg 233 704–715 Occurrence Handle10.1097/00000658-200105000-00015 Occurrence Handle1:STN:280:DC%2BD3MzisFKrsw%3D%3D Occurrence Handle11323509

  3. 3.

    PJ Conaghan E Figueira MAS Griffin CL Ingham Clark (2002) ArticleTitleRandomized clinical trial of the effectiveness of emergency day surgery against standard inpatient treatment. Br J Surg 89 423–427 Occurrence Handle10.1046/j.0007-1323.2001.02055.x Occurrence Handle1:STN:280:DC%2BD383hs1Krug%3D%3D Occurrence Handle11952581

  4. 4.

    B Edwin J Raeder E Trondsen R Kaaresen T Buanes (2001) ArticleTitleOut-patient laparoscopic adrenalectomy in patients with Conn’s syndrome. Surg Endosc 6 589–591 Occurrence Handle10.1007/s004640090021

  5. 5.

    B Edwin J Skattum J Raeder E Trondsen T Buanes (2003) ArticleTitleOut-patient laparoscopic splenectomy. Surg Endosc . .

  6. 6.

    JM Kiely AE Brannigan E Foley S Cheema W O’Brien PV Delaney (2001) ArticleTitleDay case laparoscopic cholecystectomy is feasible. Ir J Med Sci 170 98–99 Occurrence Handle1:STN:280:DC%2BD3MvksFKktA%3D%3D Occurrence Handle11491060

  7. 7.

    VB Kristiansen R Trap NC Hjortso S Schulze (2001) ArticleTitleLaparoscopic cholecystectomy in outpatient surgery. Ugeskr Laeger 163 6576–6579 Occurrence Handle1:STN:280:DC%2BD38%2Fjt1Srtw%3D%3D Occurrence Handle11760538

  8. 8.

    H Lau DC Brooks (2001) ArticleTitlePredictive factors for unanticipated admissions after ambulatory laparoscopic cholecystectomy. Arch Surg 136 1150–1153 Occurrence Handle10.1001/archsurg.136.10.1150 Occurrence Handle1:STN:280:DC%2BD3MrlvFWhsg%3D%3D Occurrence Handle11585507

  9. 9.

    H Lau DC Brooks (2002) ArticleTitleTransitions in laparoscopic cholecystectomy. The impact of ambulatory surgery. Surg Endosc 16 323–332 Occurrence Handle10.1007/s00464-001-8114-x Occurrence Handle1:STN:280:DC%2BD383jtVajsA%3D%3D Occurrence Handle11967689

  10. 10.

    H Lau DC Brooks (2002) ArticleTitleContemporary outcomes of ambulatory laparoscopic cholecystectomy in a major teaching hospital. World J Surg 26 1117–1121 Occurrence Handle10.1007/s00268-002-6264-1 Occurrence Handle12209240

  11. 11.

    S Mackay P Morgan V Datta A Chang A Darzi (2002) ArticleTitlePractice distribution in procedural skills training. Surg Endosc 16 957–961 Occurrence Handle10.1007/s00464-001-9132-4 Occurrence Handle1:STN:280:DC%2BD38vgvFGmtw%3D%3D Occurrence Handle12163963

  12. 12.

    G Mezeri F Chung (1999) ArticleTitleReturn hospital visits and hospital readmissions after ambulatory surgery. Ann Surg 230 721–727 Occurrence Handle10.1097/00000658-199911000-00016 Occurrence Handle10561098

  13. 13.

    O Mjåland J Raeder V Aasboe E Trondsen T Buanes (1997) ArticleTitleOut-patient laparoscopic cholecystectomy. Br J Surg 84 958–961 Occurrence Handle9240135

  14. 14.

    DE Pace PM Chiasson CM Schlachta J Mamazza EC Poulin (2002) ArticleTitleLaparoscopic splenectomy. Surg Endosc 16 954–956 Occurrence Handle10.1007/s00464-001-8212-9 Occurrence Handle1:STN:280:DC%2BD38vgvFGmtg%3D%3D Occurrence Handle12163962

  15. 15.

    TN Robinson WL Biffl EE Moore JK Heimbach CM Calkins JM Burch (2002) ArticleTitlePredicting failure of outpatient laparoscopic cholecystectomy. Am J Surg 184 515–519 Occurrence Handle10.1016/S0002-9610(02)01080-2 Occurrence Handle12488152

  16. 16.

    A Serralta R Garcia-Espinosa P Martinez-Casan L Hoyas M Planells (2001) ArticleTitleOutpatient laparoscopic cholecystectomy. Four years of experience. Rev Esp Enferm Dig 93 207–213 Occurrence Handle1:STN:280:DC%2BD3Mvkt1eisQ%3D%3D Occurrence Handle11488117

  17. 17.

    WT Siu HT Leong BK Law SM Onsiong KH Fung AC Li YP Tai MK Li (2002) ArticleTitleOutpatient laparoscopic cholecystectomy in Hong Kong: patient acceptance. Surg Laparosc Endosc Percutan Technol 12 139–140 Occurrence Handle10.1097/00129689-200204000-00015

  18. 18.

    JP Simpson MT Savartise J Moore (1999) ArticleTitleOutpatient laparoscopic cholecystectomy: what predicts the need for admission? Am Surg 65 525–528 Occurrence Handle1:STN:280:DyaK1M3pt1ehug%3D%3D Occurrence Handle10366206

  19. 19.

    E Trondsen B Edwin O Reiertsen H Fagertun AR Rosseland (1995) ArticleTitleSelection criteria for endoscopic retrograde cholangiopancreaticography (ERCP) in patients with gallstone disease. World J Surg 19 852–857 Occurrence Handle1:STN:280:BymC3s7gtl0%3D Occurrence Handle8553678

  20. 20.

    E Trondsen B Edwin O Reiertsen AE Færden H Fagertun AR Rosseland (1998) ArticleTitlePrediction of common bile duct stones prior to cholecystectomy. Arch Surg 133 162–166 Occurrence Handle10.1001/archsurg.133.2.162 Occurrence Handle1:STN:280:DyaK1c7ktlamtQ%3D%3D Occurrence Handle9484728

  21. 21.

    E Trondsen O Mjåland J Raeder T Buanes (2000) ArticleTitleOut-patient laparoscopic Nissens fundoplication. Br J Surg 87 1708–1711 Occurrence Handle10.1046/j.1365-2168.2000.01578.x Occurrence Handle1:STN:280:DC%2BD3M%2FnvFeqtg%3D%3D Occurrence Handle11122189

  22. 22.

    E Trondsen (2002) ArticleTitleLaparoskopiske galleoperasjoner. Tidsskr Nor Lægeforen 29 2772–2773

  23. 23.

    RM Walsh JL Ponsky J Dumot (2002) ArticleTitleRetained gallbladder/cystic duct remnant calculi as a cause of postcholecystectomy pain. Surg Endosc 16 981–984 Occurrence Handle10.1007/s00464-001-8236-1 Occurrence Handle1:STN:280:DC%2BD38vgvFGlsg%3D%3D Occurrence Handle12163968

  24. 24.

    AJ Voitk (1997) ArticleTitleIs outpatient cholecystectomy safe for high-risk elective patients? Surg Endosc 11 1147–1149 Occurrence Handle10.1007/s004649900557 Occurrence Handle1:STN:280:DyaK1c%2FktlKlsg%3D%3D Occurrence Handle9373282

  25. 25.

    AJ Voitk SGS Tsao S Ignatius (2001) ArticleTitleThe tail of the learning curve for laparoscopic cholecystectomy. Am J Surg 182 250–253 Occurrence Handle10.1016/S0002-9610(01)00699-7 Occurrence Handle1:STN:280:DC%2BD3MrktV2htQ%3D%3D Occurrence Handle11587686

  26. 26.

    AJ Voitk S Ignatius DRN Schouten RA Mustard (1998) ArticleTitleIs outpatient surgery safe for the higher risk patient? J Gastrointest Surg 2 156–158 Occurrence Handle10.1016/S1091-255X(98)80007-3 Occurrence Handle1:STN:280:DyaK1M%2FlvF2mtw%3D%3D Occurrence Handle9834412

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Correspondence to T. Buanes.

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Skattum, J., Edwin, B., Trondsen, E. et al. Outpatient laparoscopic surgery: feasibility and consequences for education and health care costs. Surg Endosc 18, 796–801 (2004). https://doi.org/10.1007/s00464-003-9180-z

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Keywords

  • Day surgery
  • Laparoscopic cholecystectomy
  • Laparoscopic fundoplication
  • Laparoscopic adrenalectomy
  • Laparoscopic splenectomy
  • Health care costs
  • Surgical education