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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 1209-1212 
    ISSN: 1432-2218
    Keywords: Key words: Gastroesophageal reflux disease — Fundoplication — Laparoscopy — Direct costs — Indirect costs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: As part of a prospective observational trial, we set out to determine the direct and indirect costs of an open versus a laparoscopic fundoplication for chronic gastroesophageal reflux disease (GERD). Methods: Two groups of patients, each comprising 28 subjects, were studied. Results: All patients received a functioning fundoplication that did not require any additional therapy. Because 19 and 12 patients in the open and laparoscopy groups, respectively, were employed in the work force, we were able to assess the costs due to loss of production. The mean operating time was similar for both groups, but postoperative stay differed significantly; though it amounted to 8 days for the open group, it was only 2 days for the laparoscopy group. Postoperative sick leave was 29.9 days in the open and 9.9 in the laparoscopy group (p 〈 0.05). The costs of the operations were 18,363 SEK for laparoscopy and 12,856 SEK for conventional fundoplication. On the other hand, the cost for hospital stay amounted to 35,488 SEK in the open group but was only 25,571 SEK for those undergoing laparoscopy. When we add outpatient visits, endoscopies, and other medical expenses, the total direct costs in the laparoscopy group come to 27,693 SEK, as compared to 37,482 SEK for the open fundoplication. The indirect medical costs, which were dominated by loss of production (36,732 versus 12,126 SEK), came to 37,126 and 12,595 SEK in the open and laparoscopy groups, respectively. Conclusions: The total community-based costs for the open and laparoscopic operations for chronic GERD amounted to 74,608 and 40,289 SEK, respectively. Thus, we would recommend the laparoscopic procedure in most cases.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 636-638 
    ISSN: 1432-2218
    Keywords: Gastroplasty ; Gastric bypass ; Morbid obesity ; laparoscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The present report describes the technical details of laparoscopic bypass for morbid obesity. Methods: The laparoscopic approach was attempted in eight patients and completed in six. In these latter patients the stomach was divided with an endoscopic linear cutter (ETC 60 Ethicon), and a antecolic jejunal loop was brought to the proximal pouch and anastomosed by use of manual suture technique supported with locking clips for knotting substitutes [Lapra-Ty (Ethicon)]. Distal to the gastrojejunostomy a side-to-side enteroanastomosis was also performed. Results: Five patients in whom the laparoscopic procedure was completed had an unevenful postoperative period and a rapid recovery. However, one patient had a postoperative left-sided pleuropneumonia that required prolonged hospital stay. Of those who were converted, one was because of a large steatotic left liver lobe and another was due to a perforation of the small intestine. Conclusions: These early results indicate that gastric bypass for the treatment of morbid obesity can be safely performed with laparoscopic techniques. Further development in this field should be encouraged.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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