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  1. Cost and benefit of the trained laparoscopic team : A comparative study of a designated nursing team vs a nontrained team.

    Article - En anglais

    Background 

    In spite of the emergence of laparoscopic cholecystectomy as the gold standard for treatment of symptomatic gallstones, questions still remain regarding its overall cost effectiveness, especially at low-volume centers where operating room (OR) time and operative complications are higher.

    We hypothesize that the presence of a well-organized, dedicated laparoscopic OR team will improve surgical outcomes for this procedure.

    This study compares the operative results of an advanced and a basic laparoscopic surgeon using either a designated laparoscopic operating team or a nondesignated team.

    Methods 

    The hospital records for 71 elective laparoscopic cholecystectomies with cholangiograms were retrospectively reviewed and anesthesia times and conversion rates were analyzed.

    Procedures were performed either at a hospital with a dedicated laparoscopy team or a hospital with nondedicated OR personnel.

    All procedures were done by an advanced laparoscopic surgeon or a basic laparoscopic surgeon.

    Results 

    Case characteristics were evenly matched between sites and surgeons.

    The mean total anesthesia time at the dedicated site was 120.8 min, compared to 152.3 min at the nondedicated site with a mean difference of 31.5 min (p=0.001).

    A 12% conversion rate was documented at the nondedicated site.

    There were no conversions at the site with a dedicated laparoscopy team.

    No major complications were encountered in this series. (...)

    Mots-clés Pascal : Laparoscopie, Etude comparative, Rapport coût bénéfice, Equipe travail, Expérience professionnelle, Evaluation, Cholécystectomie, Technique, Homme, Vésicule biliaire, Endoscopie, Appareil digestif pathologie, Economie santé, Chirurgie

    Mots-clés Pascal anglais : Laparoscopy, Comparative study, Cost benefit ratio, Work team, Professional experience, Evaluation, Cholecystectomy, Technique, Human, Gallbladder, Endoscopy, Digestive diseases, Health economy, Surgery

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0428718

    Code Inist : 002B24E08. Création : 19/12/1997.