New technology in U.S. Army health care: the role of laparoscopic cholecystectomy.
In the near future, laparoscopic cholecystectomy could become one of the most frequently performed surgical procedures in U.S. military hospitals. To determine the best way to implement this new technology in the U.S. Army Health Services Command (HSC), we have assessed the safety, efficacy, and health consequences of laparoscopic cholecystectomy. Approximately 2,800 open cholecystectomies are performed annually in HSC hospitals, 11% of them on active duty personnel. If cholecystectomies were performed using laparoscopic surgical techniques on active duty patients who meet currently accepted indications, 3,360 personnel duty days lost to convalescence and 7,048 days of limited duty (time on physical profiles) would be recouped. Applying the procedure to other beneficiaries (dependents and retired service members) would result in a potential annual savings of 11,000 hospital bed days. If implemented using stringent criteria for training and certification, these savings could be achieved with no increase in patient morbidity or mortality and with significant improvement in patient outcome.
Swann
S W
SW
Department of Surgery, Letterman Army Medical Center, Presidio of San Francisco, CA 94129-6700.
Bowersox
J C
JC
D002140:California; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004526:Efficiency; D006772:Hospitals, Military; D006801:Humans; D013677:Medical Laboratory Science; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome