Surgical innovation
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Surgical innovation · Dec 2008
Comparative StudyOutcomes of laparoscopic and open colectomy: a national population-based comparison.
Several recent clinical studies have demonstrated that laparoscopic colectomy is safe, feasible, and associated with many short-term benefits compared with open colectomy. It is unknown if outcomes observed in clinical trials can be achieved on a population level. The authors used the Nationwide Inpatient Sample to identify laparoscopic and open elective colon resections performed in the United States for each year from 2000 to 2004. ⋯ After adjusting for patient characteristics and comorbidities, laparoscopic colectomy was associated with lower in-hospital mortality (0.6% vs 1.7%, P < .001), lower overall complication rate (32.1% vs 38.2%, P < .001), and shorter median hospital stay (5 vs 7 days, P < .001) compared with open colectomy. Significant benefits were observed in wound problems (0.8% vs 1.44%, P < .001); cardiovascular (12.5% vs 15.1%, P < .001), pulmonary (6.2% vs 8.7%, P < .001), and gastrointestinal (13.7% vs 16.1%, P < .001) morbidity; and reintervention rates (1.33% vs 1.66%, P = .02). Outcome benefits of laparoscopic colectomy previously demonstrated in clinical trials are observed on a population level.
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Surgical innovation · Dec 2008
Patient perception of medicare fee schedule of laparoscopic procedures.
It seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient perception and opinion of Medicare reimbursements to surgeons related to laparoscopic surgery. Our hypothesis was that patients think the surgeon Medicare fee schedule is higher than actuality. ⋯ Most of our patients overestimated what Medicare currently pays for some laparoscopic procedures. Surgeons need to do a better job in educating patients and the general public about the Medicare fee schedule.
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Surgical innovation · Dec 2008
Biography Historical ArticleAn unsung hero of the laparoscopic revolution: Eddie Joe Reddick, MD.