Rarely do individuals enjoy staying in the hospital, especially when the stay involves surgery. New techniques in surgery are enabling patients to undergo less-invasive procedures that require less recovery time. One new technique is total laparoscopic hysterectomy (TLH), which removes the uterus from women who require a hysterectomy due to conditions such as endometriosis. Since this surgical technique is relatively new, a group of researchers conducted a study that compared the safety of in-patient and out-patient TLH procedures and found that same-day discharge is feasible and safe even for women with endometriosis.
“Although ambulatory hysterectomies could lead to significant cost savings, some experts fear the effects of what could be premature postsurgical discharge,” stated the authors, giving motivation for conducting the case study, which was entitled “Feasibility and Safety of Outpatient Total Laparoscopic Hysterectomy” and published in Journal of the Society of Laparoendoscopic Surgeons. The team at Center Hospitalier de Québec followed 128 patients receiving out-patient TLH (discharged before midnight on the day of surgery) to identify any negative impacts on the patients’ health. The follow-up period lasted three months.
The TLH procedure requires general anesthesia and uses four ports in a patient’s body for inserting surgical tools and visualizing cameras and lights. Patients were allowed to be discharged if they did not experience complications or pain, if they could walk, and if their wounds were unremarkable.
During the three month follow-up period, women were instructed on the warning signs that indicate the need for a physician’s advice or a consultation in an emergency room. Proactively, a nurse called each patient the day after surgery to ensure everyone was safe. Only 4 patients (3.1%) returned for medical help three days after the procedure, and only 17% sought advice in the three-month span. Of the 17%, only six patients needed to be readmitted. There was no difference in readmission between the out-patient women and the in-patient women that could not be discharged for various reasons.
“The surgical technique for TLH is constantly changing, to improve efficiency and patient safety,” stated the authors. The research team identified that women with endometriosis show no difference in readmission, indicating that it is safe for these patients to undergo out-patient TLH.