LAPAROSCOPIC HYSTERECTOMY SURGERY
Cheaper, safer, yet still rare
Hysterectomies are the second most common surgical procedure performed on women. Studies show surgeons perform roughly 600,000 hysterectomies each year in the United States. However, less than 1% of these surgeries take place in an ambulatory surgery center (ASC). Dr. Richard Rosenfield of the Pearl Surgery Center is trying to change that. That change, though, has been an uphill battle because few surgeons have the necessary training and there are still general uncertainties surrounding the Affordable Care Act.
“Innovation has not only improved the technology but we can do laparoscopic hysterectomies more efficiently and at a lower cost than hospitals”, Dr. Rosenfield explains. Citing a recent study, laparoscopic hysterectomies performed at a hospital cost on average $8,868 compare to roughly $4,000 for the same procedure performed at an ASC. Not only would an ASC be more cost effective but there is also no overnight stay. “Outpatient laparoscopic hysterectomy is safe, feasible, and cost effective when performed in the setting of a freestanding ambulatory surgical center with the same-day discharge home.” Dr. Rosenfield reiterates. Vaginal and laparoscopic hysterectomies have been associated with decreased blood loss, shorter hospital stays, a speedier return to normal activities and fewer abdominal wall infections.
Given that information, why is it still rare for an ASC to perform a laparoscopic hysterectomy when we know that they are safe and affordable? Studies show the relatively slow adaptation of laparoscopic hysterectomy with an ASC may in part be attributed to inadequate exposure and training during residency. Researchers also add that relatively low reimbursement rates may also curb provider enthusiasm for additional training and incorporation of the laparoscopic hysterectomy into their surgical armamentarium.
How can an ASC boost their volume in performing more laparoscopic hysterectomies? Dr. Rosenfield says, “The problem is the typical ObGyn doctor does not have as high a volume for surgery as other specialties, some need to develop expertise.” The tools are there, and with more education and exposure the end goal is attainable. Rewards await those who meet the changing environment with new skills and new offerings.