Creative Ways to Impact Cost of Care for Laparoscopies

5/30/2023

Cost of care is on track to be one of the year’s most critical issues in healthcare. With inflation reaching all-time highs, the pressure of economic procurement is heavy.

Also increasing is the accountability of all leaders in the operating room to contribute to financial responsibility, while still delivering exceptional patient outcomes.

The healthcare industry is carefully balancing demands for increased quality at decreased costs…but do you have the tools to do so properly?

UC Davis made headlines recently for being the first multi-site health system in the U.S. to implement low pressure insufflation for all laparoscopic and robotic-assisted procedures.

“Since 2016, we have been utilizing low pressure insufflation for our robotic surgery procedures and have found success in improving patient outcomes and improving operating efficiency for our robotic surgeons,” said Bahareh M. Nejad, Director of Robotic Surgery. “We are proud UC Davis Health has made this investment to expand this benefit for all surgical laparoscopic procedures.”

How does low pressure impact outcomes and efficiency?
Studies across multiple specialties noted procedural benefits, such as stable pneumoperitoneum, consistent surgical exposure, and improved intraoperative respiratory parameters.1,2,4,5,6-8

Studies using a low-pressure approach with AirSeal® in laparoscopic surgery have concluded that patients may experience a reduction in postoperative pain.2,3,5,8-12 Additional documented patient benefits include reduced PACU times,1,2 length of stay,1,2 reduced 30-day ER visits,3 and readmissions.3

These benefits make an impact on overall patient care and cost of care.
 
“If patients feel better after their operation, we’re able to send them home.” Dr. Nejad says, sharing her experience with AirSeal®. “If our recovery rooms are full then we can’t move on to the next patient. And so, it helps the hospital and everyone overall if we can get the patients home faster.”

Curious how AirSeal® could impact your institution? Learn more here.

 

1 Bucur P, Hofmann M, Menhadji A, et al. Comparison of Pneumoperitoneum Stability Between a Valveless Trocar System and Conventional Insufflation: A Prospective Randomized Trial. Urology. 2016;94:274-280. doi:10.1016/j.urology.2016.04.022.
2 Ramshaw B, Forman B, Heidel E, Dean J, Gamenthalar A, Fabian M. A Clinical Quality Improvement (CQI) Project to Improve Pain After Laparoscopic Ventral Hernia Repair. Surg Technol Int. 2016;29:125-130.
3 Ferroni, M. C., & Abaza, R. (2019). Feasibility of robot-assisted prostatectomy performed at ultra-low pneumoperitoneum pressure of 6 mmHg and comparison of clinical outcomes vs standard pressure of 15 mmHg. BJU international, 124(2), 308-313. https://doi.org/10.1111/bju.14682
4 Sroussi, J., Elies, A., Rigouzzo, A., Louvet, N., Mezzadri, M., Fazel, A., & Benifla, J. L. (2017). Low pressure gynecological laparoscopy (7mmHg) with AirSeal® System versus a standard insufflation (15mmHg): A pilot study in 60 patients. Journal of gynecology obstetrics and human reproduction, 46(2), 155–158. https://doi.org/10.1016/j.jogoh.2016.09.003
5 Foley CE, Ryan E, Huang JQ. Less is more: clinical impact of decreasing pneumoperitoneum pressures during robotic surgery. J Robot Surg. 2021;15(2):299-307. doi: 10.1077/s11701-020-01104-4c.
6 Nepple KG, Kallogjeri D, Bhayani SB. Benchtop evaluation of pressure barrier insufflator and standard insufflator systems. Surg Endosc. 2013 Jan;27(1):333-8. doi: 10.1007/s00464-012-2434-x. Epub 2012 Jul 26. PMID: 22833262.
7 Covotta M, Claroni C, Torregiani G, et al. A Prospective, Randomized, Clinical Trial on the Effects of a Valveless Trocar on Respiratory Mechanics During Robotic Radical Cystectomy: A Pilot Study. Anesth Analg. 2017;124(6):1794-1801. doi:10.1213/ANE.0000000000002027
8 Saway JP, McCaul M, Mulekar MS, McMahon DP, Richards WO. Review of Outcomes of Low Verses Standard Pressure Pneumoperitoneum in Laparoscopic Surgery. Am Surg. 2022;88(8):1832-1837. doi:10.1177/00031348221084956
9 Ramshaw B, Vetrano V, Jagadish M, Forman B, Heidel E, Mancini M. Laparoscopic approach for the treatment of chronic groin pain after inguinal hernia repair : Laparoscopic approach for inguinodynia. Surg Endosc. 2017;31(12):5267-5274. doi:10.1007/s00464-017-5600-3
10 Abaza R, Martinez O, Ferroni MC, Bsatee A, Gerhard RS. Same Day Discharge after Robotic Radical Prostatectomy. J Urol. 2019;202(5):959-963. doi:10.1097/JU.0000000000000353
11 Buda A, Di Martino G, Borghese M, et al. Low-Pressure Laparoscopy Using the AirSeal System versus Standard Insufflation in Early-Stage Endometrial Cancer: A Multicenter, Retrospective Study (ARIEL Study). Healthcare (Basel). 2022;10(3):531. Published 2022 Mar 14. doi: 10.3390/healthcare10030531.
12 Celarier S, Monziols 13 S, Célérier B, et al. Low-pressure versus standard pressure laparoscopic colorectal surgery (PAROS trial): a phase III randomized controlled trial. Br J Surg. 2021;108(8):998-1005. doi:10.1093/bjs/znab069 *When compared to standard insufflation