Lowering Length of Stay for Laparoscopic Procedures


In September, Becker’s Hospital Review published an article on steps C-Suite leaders are taking to improve their bottom line. One area shows promise to make a big impact… Reducing length of stay.

Reducing costs by reducing a patient’s length of stay is not a new concept. However, implementing a strategy to consistently and effectively do so can be more complex.

Length of stay (LOS) has drawn more attention because of the controllability, versus other financial areas of concern caused by inflation, supply chain, or staffing shortages.

With reimbursement being used as a change driver across global healthcare systems, leaders are eager to implement improvements that complement Value-Based Purchasing standards, including shortened length of stay, reduced readmissions, and more.

Hospitals are evaluating discharge processes and other opportunities to get patients home quicker. By reducing patient LOS, hospitals are subsequently reducing costs for the patient and healthcare system, reducing the risk of hospital-acquired complications, and improving patient satisfaction.

“Reducing the length of stay also leads to better outcomes, which is especially crucial as health systems transition to value-based care,”  Laura Dyrda writes in her Becker’s article.  

However some leaders have expressed concern that focusing too much on reducing LOS could unintentionally increase the risk of readmissions.

Could technology bridge this gap?

In 2022, UC Davis Health System implemented technology that helped them improve efficiency and patient outcomes across all their laparoscopic procedures. It’s also helping them decrease inpatient and PACU time.

“The faster we can get people out of recovery - even if it is just minutes - it helps our surgeons be able to proceed with our next procedure and provide more care to our patients,” said Dr. Bahareh M. Nejad, Director of Robotic Surgery and Clinical Professor of Obstetrics and Gynecology.

In September, Dr. Vedra Augenstein presented her Poster of Distinction at the American Hernia Society’s 2023 Meeting, titled A Clinical Quality Improvement (CQI) Project for Ventral Hernia Repair (VHR): Assessing Long-Acting Local Anesthetic and Low-Pressure Pneumoperitoneum.

Dr. Augenstein showcased her team’s 3-year data collected to date for a study evaluating 101 patients who underwent minimally invasive hernia repair. Comparing outcomes for patients who underwent surgery using a valve-less low-pressure insufflator, versus conventional insufflation, Dr. Augenstein was able to document discharge times of 1.3 days less for patients in the low pressure group* compared to the standard insufflation patient group.1

Her clinical evidence also suggests postoperative pain scores were lower when comparing outcomes using AirSeal® at low pressure versus standard insufflation.1

Dr. Nejad has noticed this difference for her patients too, contributing it to their reduction in PACU times. “If patients feel better after their operation, we’re able to send them home. If our recovery rooms are full then we can’t move on to the next patient,” she shared. “And so, it helps the hospital and everyone overall if we can get the patients home faster.”

To date, five clinical studies (including Dr. Augenstein’s poster) have documented that operating at lower pressure with AirSeal® can reduce a patient’s LOS while optimizing outcomes. This is empowering healthcare facilities to confidently minimize LOS without compromising care. 


* Low pressure group utilized AirSeal iFS to achieve low pressure and stable pneumoperitoneum 
1 Wilson, H, et al. A Clinical Quality Improvement (CQI) Project for Ventral Hernia Repair (VHR): Assessing Long-Acting Local Anesthetic and Low-Pressure Pneumoperitoneum. 2022. Poster of Distinction. https://Custom.Cvent.Com/9D6126EEBC1B404DA11E747D5B4411CE/Files/3869644d0b824b398d4c3e1dcc71b745.Pdf