July 1997
JAPANESE, U.S., BELGIAN SURGEONS USE MINI-CABG* DEVICES FOR MULTI-BYPASS
Dr. Go Watanabe and a Japanese surgical team in March successfully completed the world's first minimally invasive triple coronary artery bypass procedure with United States Surgical Corporation's (USSC) Mini-CABG* instruments. The team operated on a 69-year-old woman without stopping her heart, avoiding the significant costs and potential complications associated with heart-lung bypass equipment. Shortly after, Dr. John Puskas, Emory University, performed this groundbreaking procedure for the first time in the United States. In June, Pr. D. de Canniere of Erasme Hospital, the academic hospital of Brussels University in Belgium, headed the first surgical team in Europe to complete a triple bypass with USSC's instruments.
Dr. Watanabe, Toyama Medical and Pharmaceutical University in Toyama, points out, "We are heading into a new era of bypass surgery with the ability to repair a heart while it continues to beat. The Mini-CABG* instruments eliminate the need for a heart-lung machine, which means less chance of complications and a faster recovery for patients, and a substantial cost savings for hospitals."
NEW ENGLAND JOURNAL: LAP HERNIA OFFERS QUICK RECOVERY, LOW RECURRENCE
A study published in The New England Journal of Medicine (May, 1997, Vol. 336, No. 22) comparing the outcomes of laparoscopic inguinal-hernia repair and the conventional approach found that the laparoscopic technique offered several advantages, including a quicker return to normal activities and lower recurrence rates.
The randomized, multi-center study conducted in the Netherlands compared 487 patients treated laparoscopically and 507 patients who had open surgery. Researchers found that, on average, all of the laparoscopic patients were back to normal activities within 6 days and returned to work within 2 weeks. In addition, they were able to exercise 3 weeks after surgery. In contrast, patients who had open surgery averaged a 10-day convalescence period, 3 weeks recovery before returning to work and a 36-day wait until resuming physical activities. The study also found recurrence rates for laparoscopic hernia repair to be just 3% (17 patients), compared to 6% (31 patients) for open surgery.
HEARTBURN SUFFERERS MAY BE ABLE TO SPELL RELIEF... PERMANENTLY
Laparoscopic Nissen fundoplication provides permanent relief for chronic heartburn sufferers, according to an article in Today's Surgical Nurse (January/February 1997).
Although effective in treating chronic heartburn, known as gastroesophageal reflux disease (GERD), traditional Nissen fundoplication is highly invasive, requiring a 6- to 10-inch incision, followed by a 6- to 10-day hospital stay and up to 2 months of painful recovery. To spare the patient the physical and emotional trauma of open surgery, surgeons are performing the same procedure laparoscopically.
To treat GERD, surgeons must strengthen the valve between the stomach and the esophagus to eliminate the upward surge of stomach acids. When the procedure is completed laparoscopically, "...visualization is superior than with the traditional approach... and the operation is easier," says Dr. Garth Ballantyne, director, minimally invasive surgery, Hackensack University Medical Center in New Jersey. Patients typically leave the hospital in 2 or 3 days and are back to normal activities within a week. Most important, chronic sufferers find relief that long-term drug therapy could not provide.
.... AND PERMANENT RELIEF MAY EVEN RESULT FROM SAME-DAY SURGERY
Now that outpatient laparoscopic cholecystectomy is accepted as safe and effective, many surgical teams are suggesting that other more complex procedures can be performed in an outpatient setting, offering increased patient benefits and significant cost savings (Laparoscopic Surgery Update, May 1997).
According to Dr. Philip Raymond Schauer, University of Pittsburgh Medical
Center, Laparoscopic Nissen fundoplication can be safely performed on an
outpatient basis when strict criteria are used to select potential patients.
In a small study of 9 patients at the medical center, all were discharged
the same day at a cost of $5,560 per procedure. This represents a cost
savings of 29% when compared to the average inpatient procedure of $7,792.
Researchers report that of the 9 cases, there were no operative complications,
no patients were readmitted and all patients were happy with their surgery.
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.
