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Advanced Laparoscopic Surgery in a Free-Standing Ambulatory Setting

Lessons From the First 50 Cases

Département de Chirurgie, Centre Hospitalier Universitaire de Québec, Québec, jpgmj{at}videotron.ca

Omar Al-Obeed, MD

Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada

Shaheer Tadros, MD

Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada

Vijay Moonje, MD

Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada

Jean-Denis Yelle, MD

Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada

Eric C. Poulin, MD

Department of Surgery, The Ottawa Hospital, University of Ottawa, Ontario, Canada

To decrease the impact and cost of surgery, there is a trend toward developing treatment models for complex conditions on a fully outpatient basis. This is a retrospective study of the initial experience of advanced laparoscopic procedures performed on a same-day outpatient basis in the ambulatory campus of a university hospital. Over 3 years, 55 patients underwent 50 Nissen fundoplications and 5 adrenalectomies. There were 2 intraoperative complications, with no mortality and no conversion. The median postoperative stay was 4.5 hours. Readmission at 1 month was 11%. Data on the nursing postoperative telephone follow-up were available for 50 patients; 34 (62%) were successfully contacted.Twenty four (70%) had no complaint. Preliminary high-level cost data indicate a cost advantage. Advanced laparoscopic procedures can be done safely in a pure ambulatory setting; the current readmission rate can be reduced with improved pain management and better telephone follow-up strategies. Cost savings are likely.

Key Words: ambulatory surgical procedures • fundoplication • gastroesophageal reflux • laparoscopy • adrenalectomy • outcome assessment (health care)

Surgical Innovation, Vol. 14, No. 1, 12-17 (2007)
DOI: 10.1177/1553350606298718


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