Surgical laparoscopy & endoscopy
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Surg Laparosc Endosc · Dec 1991
In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospitalization charges.
The safety of laparoscopic cholecystectomy has been demonstrated through its increased use, and we have performed 114 of these operations as outpatient procedures. These patients have done well and hospitalization charges have been reduced substantially. Of 622 laparoscopic cholecystectomies performed from November 1989 to March 1991, 114 were done on an outpatient basis if the patients were generally healthy, lived nearby, and the operative procedure was uneventful. ⋯ D., A. A.), 43 were performed as outpatients using the above selection criteria. 44 were held for 23-h observation, and 13 were inpatients. The average hospital charge for 377 uncomplicated morning-admitted inpatient standard cholecystectomy patients was $4,250.00, compared with $2,293.02 for 106 outpatient laparoscopic cholecystectomy patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Two sets of experiments were conducted to determine whether the potential hazards of secondary sparking and distal tissue burns are a serious risk for surgeons using monopolar electrosurgery during laparoscopy. The results indicate that secondary sparking poses little threat, whereas distal burns are very likely, given certain tissue parameters that force the entire electric current through narrow structures.