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


CONCLUSIONS
Ambulatory laparoscopic surgery is cost effective, patient friendly, and appropriate for surgical resident training. Strict organization of security rules is mandatory.
Skattum
J
J
Gastrosurgical Department, Ullevaal University Hospital, Oslo, Norway.
Edwin
B
B
Trondsen
E
E
Mjåland
O
O
Raede
J
J
Buanes
T
T
D000315:Adrenalectomy / Q000191:economics / Q000379:methods; D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000193:education*; D017081:Cholecystectomy, Laparoscopic / Q000191:economics; D003362:Cost-Benefit Analysis; D018662:Fundoplication / Q000191:economics / Q000379:methods; D013502:General Surgery / Q000193:education*; D017048:Health Care Costs; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000191:economics*; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000193:education; D009664:Norway; D011446:Prospective Studies; D013156:Splenectomy / Q000191:economics / Q000379:methods