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Related Experiment Videos

Ambulatory laparoscopic fundoplication

M A Milford1, T A Paluch

  • 1Department of Surgery, Kaiser Foundation Medical Center, 4647 Zion Avenue, San Diego, CA 92120, USA.

Surgical Endoscopy
|December 31, 1997
PubMed
Summary
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Laparoscopic fundoplication (LF) can be safely performed as an outpatient procedure. Tailored pain management and anesthesia minimize nausea and ensure patient comfort for same-day discharge.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Anesthesiology

Background:

  • Laparoscopic fundoplication (LF) is increasingly performed, with shortened hospital stays being a key benefit.
  • Typical lengths of stay (LOS) for LF are 2-3 days, but one institution achieved 1-day LOS.
  • This success prompted an investigation into performing LF on an ambulatory (outpatient) basis.

Purpose of the Study:

  • To evaluate the safety and feasibility of performing laparoscopic fundoplication (LF) as an ambulatory procedure.
  • To assess patient outcomes, including pain, nausea, and satisfaction, following same-day discharge after LF.

Main Methods:

  • Sixty-one patients undergoing LF were included; 57 had same-day discharge attempted.
  • Preemptive analgesia included ketorolac and local bupivacaine; anesthesia minimized narcotics.

Related Experiment Videos

  • Patients received oral fluids/solids post-recovery, with discharge within 5 hours.

    • Main Results:

    • Three of 57 patients required overnight hospitalization due to pain, nausea, or urinary retention.
    • No adverse outcomes were linked to early discharge, and no readmissions occurred.
    • Median discharge time was under 5 hours, with no patient dissatisfaction reported.

    Conclusions:

    • Laparoscopic fundoplication (LF) is a safe ambulatory procedure.
    • Optimized analgesic and anesthetic strategies are crucial for minimizing nausea and controlling pain.
    • Ambulatory LF can be successfully implemented with appropriate patient selection and management.