Outpatient laparoscopic appendectomy

Abstract

Laparoscopy has allowed surgeons the ability to perform procedures which result in less postoperative discomfort, earlier return to daily activities, and better cosmesis. For example, laparoscopic cholecystectomy has virtually replaced open cholecystectomy, and many of these operations are performed in the outpatient setting. The role of laparoscopic appendectomy is yet to be defined, however. Over an 18-month period from February 1992 to July 1993, 75 laparoscopic appendectomies were performed at Kaiser Permanente Medical Center in Los Angeles. Thirty-five of the patients undergoing this procedure were outpatients. While there were a total of three complications, including two intraabdominal abscesses, there were no complications in the outpatient appendectomy group. Laparoscopic appendectomy may be safely performed in the outpatient setting in patients with acute nonperforated appendicitis.

Outpatient Laparoscopic Appendectomy: Feasible in a Public County Hospital?

“…In a system where bundled payments and patient satisfaction can play an increasing role, these are very real concerns. 20 In one of the earliest reports of outpatient appendectomy, Jain and colleagues 21 found success in the selective use of outpatient appendectomy for 35 of 75 patients with acute uncomplicated appendicitis without an increase in complications. This has also been seen in the pediatric population; Alkhoury and colleagues 11 successfully treated 80% of 158 eligible patients with outpatient laparoscopic appendectomy, resulting in decreased length of stay without increases in complications and with good parent satisfaction with the technique.…”

Outpatient laparoscopic adrenalectomy in patients with Conn's syndrome

“…Outcome parameters such as postoperative pain, hospital stay, and convalescence time are significantly improved with the laparoscopic technique, and complication rates are lower [6,12,16]. However, since long operative times lead to a significant increase in hospital costs, overall hospital charges for open and laparoscopic adrenalectomy have not been shown to be significantly different [7,12].Several comprehensive laparoscopic procedures have been performed in an ambulatory setting with good results [1,3,8,9,19]. Our department is now focusing on the development of same-day surgery, and we have already published a prospective series of outpatient laparoscopic cholecystectomies [10,11] and outpatient laparoscopic Nissen fundoplications [18].…”

“…Several comprehensive laparoscopic procedures have been performed in an ambulatory setting with good results [1,3,8,9,19]. Our department is now focusing on the development of same-day surgery, and we have already published a prospective series of outpatient laparoscopic cholecystectomies [10,11] and outpatient laparoscopic Nissen fundoplications [18].…”

Outpatient laparoscopic splenectomy: patient safety and satisfaction

“…Several types of comprehensive laparoscopic procedures have been performed in an ambulatory setting with good results [9,10,12,21]. Prospective series of laparoscopic cholecystectomy [13,14], laparoscopic Nissen fundoplication [25], and laparoscopic adrenalectomy [5], performed with same-day discharge (SDD), have previously been reported by our department.…”