[Laparoscopy: potential and limitations in outpatient and short-term inpatient surgery].
Many laparoscopic operations can usually be performed on an outpatient or at least short-term inpatient basis. Since the postoperative risk is easily estimated and can be determined on the 1st or 2nd postoperative day, it quickly becomes clear whether the healing process will be undisturbed or complications will occur. Prerequisites are comprehensive information to the patient as well as his cooperation and that of his social setting. From a medical standpoint, suitable administrative and infrastructural conditions must be arranged that enable safe, efficient preop preparation and guarantee reliable postoperative care of the patient. The newly begun shift in the German health care delivery system toward outpatient and short-term inpatient treatment must be introduced carefully and step by step, since the resultant reduction in postoperative inpatient care goes hand in hand with reduced patient comfort and without question places a greater burden on the patient's social setting.Clearly, optimal collaboration with local doctors is necessary to accompany this nationwide reduction in hospital stay, and the distribution of responsibility among the various physicians must be clarified. However, independently these elements, the success of outpatient and short-term inpatient laparoscopy still can be guaranteed only by surgeons' high experience and minimal complications.
Feussner
H
H
Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Munich. feussner@nt1.chir.med.tu-muenchen.de
D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D000075202:Contraindications; D003430:Cross-Sectional Studies; D018662:Fundoplication / Q000706:statistics & numerical data; D005858:Germany; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000706:statistics & numerical data; D007902:Length of Stay; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000592:standards; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011785:Quality Assurance, Health Care / Q000592:standards