United States Surgical Corporation (USS) recently launched a new site on the World Wide Web -- The Surgical Resource Network -- "to provide a user-friendly source of timely information about new developments in healthcare in general and USS in particular," said Leon C. Hirsch, chairman of USS.

The Surgical Resource Network (/), introduced at the company's annual meeting in May, offers the latest information about surgical procedures, new clinical developments, innovative instrumentation, education and training for clinicians, cost-containment, resources for patients and company information for investors and the public. Past issues of The Laparoscopy Report can be found on the "Medical News" page.

 

LAPAROSCOPIC INCISIONAL HERNIA REPAIR MORE COST-EFFECTIVE THAN OPEN APPROACH

While numerous papers have reported that laparoscopic surgery is effective for repairing inguinal hernias -- the most common type -- Theodore Pappas, MD, and colleagues at Duke University Medical Center in Durham, NC, now have research indicating laparoscopic incisional hernia repair may also offer hospitals and patients major cost savings over traditional "open" surgery (Laparoscopic Surgery Update, June 1996).

The Duke researchers compared the hospital costs and patient charges for 10 patients undergoing open surgery to repair incisional hernias -- hernias that appear at the site of a previous surgical incision -- versus 11 undergoing a laparoscopic repair. They found that the significantly shorter hospital stay following laparoscopic surgery (1.4 vs. 5 days) had the largest influence on costs and charges. While the open procedure cost the hospital an average of $6,649 ($9,210 patient charge), the laparoscopic approach cost only $3,719 ($6,383 patient charge), a savings of 44% for the hospital and 30% for the patient.

 

LAPAROSCOPICALLY ASSISTED VAGINAL HYSTERECTOMY SHORTENS HOSPITAL STAY & RECOVERY

A preliminary study by Robert L. Summitt Jr., MD, Memphis, TN, found that in cases where women are not candidates for a vaginal hysterectomy, laparoscopically assisted vaginal hysterectomy (LAVH) results in a significantly shorter hospital stay and convalescent period than total abdominal hysterectomy (TAH), according to a report in the July 1, 1996 issue of OB. GYN. News.

Dr. Summitt's findings, presented at the annual clinical meeting of the American College of Obstetricians and Gynecologists, included a comparison between 29 women randomized for TAH and 26 for LAVH. The study found that LAVH patients experienced a shorter average hospital stay than TAH patients (1.9 vs. 4.2 days) and a faster return to work and normal activities (25.9 vs. 37.4 days). There was a higher incidence of wound complication in the TAH group, but there was no significant difference between the two procedures in operating time, blood loss and complications during or following surgery.

 

DENVER SURGEON FINDS LAPAROSCOPIC SURGERY CAN BE SAFE FOR PREGNANT PATIENTS . . .

Based on their initial experience, Barbara S. Schwartzberg, MD and other surgeons at Columbia Rose Medical Center in Denver suggest that laparoscopic surgery can be safe and effective during the early stages of pregnancy (Laparoscopic Surgery Update, May 1996).

Dr. Schwartzberg reported her experience with first-trimester laparoscopy at the 1996 annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) in Philadelphia. In the case of a 30-year-old woman who was eight weeks pregnant with right lower abdominal pain, laparoscopy revealed a ruptured ovarian cyst and an inflamed appendix. A successful laparoscopic appendectomy was performed and a healthy baby was delivered 29 weeks later. In another case, symptomatic cholelithiasis (the formation of painful stones in the gallbladder or common bile duct) threatened the twin pregnancy of a 31-year-old patient who was 8.5 weeks pregnant. Dr. Schwartzberg was able to successfully remove the gallbladder laparoscopically with no postoperative complications.

 

. . . OTHERS REPORT SIMILAR FINDINGS FOR PREGNANT GALLBLADDER, APPENDECTOMY PATIENTS

Two other Colorado surgeons, A. Tayfun Gurbuz, MD and Michael E. Peetz, MD, urged those attending the annual SAGES conference to consider laparoscopy when addressing acute abdominal pain in pregnant patients. (Laparoscopic Surgery Update, May 1996).

Over the past three years, Drs. Gurbuz and Peetz have treated 47 women with severe abdominal pain during pregnancy. Of the 23 women who required surgical intervention during pregnancy, 10 underwent laparoscopic gallbladder removal, five had laparoscopic appendectomy and one had laparoscopic exploratory surgery followed by an open appendectomy. The remaining 7 patients underwent various open procedures. There were no cases of congenital malformations or fetal loss as a result of laparoscopy, although they caution that both the mother and fetus should be monitored closely during and following the procedure.


For more information, contact Steve Rose, editor, at 203-845-1732 or E-mail to [email protected].

Items marked by an * and The Laparoscopy Report are trademarks of USSC.





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