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Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center

BACKGROUND/OBJECTIVES: It has been shown that major gynecologic laparoscopy is safe in hospital ambulatory settings, but there is little data to suggest the same in freestanding ambulatory surgery centers. This study evaluates the safety and efficacy of advanced gynecologic laparoscopic surgery usin...

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Autores principales: Nezhat, Camran, Main, Jillian, Paka, Chandhana, Soliemannjad, Rose, Parsa, M. Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154421/
https://www.ncbi.nlm.nih.gov/pubmed/25392631
http://dx.doi.org/10.4293/JSLS.2014.00291
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author Nezhat, Camran
Main, Jillian
Paka, Chandhana
Soliemannjad, Rose
Parsa, M. Ali
author_facet Nezhat, Camran
Main, Jillian
Paka, Chandhana
Soliemannjad, Rose
Parsa, M. Ali
author_sort Nezhat, Camran
collection PubMed
description BACKGROUND/OBJECTIVES: It has been shown that major gynecologic laparoscopy is safe in hospital ambulatory settings, but there is little data to suggest the same in freestanding ambulatory surgery centers. This study evaluates the safety and efficacy of advanced gynecologic laparoscopic surgery using a fast-track model in freestanding ambulatory surgery centers and discusses our institution protocols. METHODS: Retrospective, multicenter review was conducted of major gynecologic surgeries from August 1(st) 2010 to September 30(th) 2011 in 3 surgical centers with one primary surgeon. All patients were treated for symptomatic uterine leiomyomas and/or endometriosis. Primary outcome measures were unplanned admissions and discharge within 23 hours. RESULTS: One hundred and thirty-four patients underwent major laparoscopic gynecologic surgery with a total of 160 procedures: 77 stage IV endometriosis treatment including 7 disk excisions of endometriosis from the large bowel, 3 ureteroneocystostomies and 1 partial bladder resection, 38 myomectomies, and 34 hysterectomies including 12 modified radical hysterectomies. The overall unplanned admission rate was 4.5%. One hundred and thirty-one patients (97.7%) were discharged within 24 hours after surgery. Three patients (2.2%) were transferred to the hospital postoperatively: 1 patient for observation of postoperative anemia and 2 patients for postoperative fever. Three patients (2.2%) were admitted to the hospital after discharge: 1 patient for postoperative ileus, 1 patient for postoperative fever, and 1 patient with septic pelvic thrombophlebitis. These postoperative issues all resolved without complication, and all patients had an uneventful follow-up. CONCLUSIONS: With appropriate resources and an experienced surgeon, advanced laparoscopic surgery can be safely performed in a fast-track ambulatory surgery center with a high rate of discharge within 23 hours and low unplanned readmission rate.
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spelling pubmed-41544212014-09-08 Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center Nezhat, Camran Main, Jillian Paka, Chandhana Soliemannjad, Rose Parsa, M. Ali JSLS Scientific Papers BACKGROUND/OBJECTIVES: It has been shown that major gynecologic laparoscopy is safe in hospital ambulatory settings, but there is little data to suggest the same in freestanding ambulatory surgery centers. This study evaluates the safety and efficacy of advanced gynecologic laparoscopic surgery using a fast-track model in freestanding ambulatory surgery centers and discusses our institution protocols. METHODS: Retrospective, multicenter review was conducted of major gynecologic surgeries from August 1(st) 2010 to September 30(th) 2011 in 3 surgical centers with one primary surgeon. All patients were treated for symptomatic uterine leiomyomas and/or endometriosis. Primary outcome measures were unplanned admissions and discharge within 23 hours. RESULTS: One hundred and thirty-four patients underwent major laparoscopic gynecologic surgery with a total of 160 procedures: 77 stage IV endometriosis treatment including 7 disk excisions of endometriosis from the large bowel, 3 ureteroneocystostomies and 1 partial bladder resection, 38 myomectomies, and 34 hysterectomies including 12 modified radical hysterectomies. The overall unplanned admission rate was 4.5%. One hundred and thirty-one patients (97.7%) were discharged within 24 hours after surgery. Three patients (2.2%) were transferred to the hospital postoperatively: 1 patient for observation of postoperative anemia and 2 patients for postoperative fever. Three patients (2.2%) were admitted to the hospital after discharge: 1 patient for postoperative ileus, 1 patient for postoperative fever, and 1 patient with septic pelvic thrombophlebitis. These postoperative issues all resolved without complication, and all patients had an uneventful follow-up. CONCLUSIONS: With appropriate resources and an experienced surgeon, advanced laparoscopic surgery can be safely performed in a fast-track ambulatory surgery center with a high rate of discharge within 23 hours and low unplanned readmission rate. Society of Laparoendoscopic Surgeons 2014 /pmc/articles/PMC4154421/ /pubmed/25392631 http://dx.doi.org/10.4293/JSLS.2014.00291 Text en © 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Nezhat, Camran
Main, Jillian
Paka, Chandhana
Soliemannjad, Rose
Parsa, M. Ali
Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title_full Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title_fullStr Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title_full_unstemmed Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title_short Advanced Gynecologic Laparoscopy in a Fast-Track Ambulatory Surgery Center
title_sort advanced gynecologic laparoscopy in a fast-track ambulatory surgery center
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154421/
https://www.ncbi.nlm.nih.gov/pubmed/25392631
http://dx.doi.org/10.4293/JSLS.2014.00291
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