Endoscopic Surgery

Study Presented to European Association for Endoscopic Surgery

In 2000, Dr. Finley and Dr. J. Barry McKernan presented their findings from a study of 557 consecutive patients treated for gastro-esophageal reflux disease (GERD) at the Advanced Surgery Center of Georgia, an outpatient surgery center located north of Atlanta. It was conducted from June 1995 to December 1999.

The study, presented at the 8th International Congress of the European Association for Endoscopic Surgery in France, revealed that the minimally invasive procedure called laparoscopic fundoplication can be performed safely in an outpatient surgery center. All 557 patients were discharged in less than 23 hours, and none of them required conversion to an open procedure.

Conversion means that a surgery begun as a minimally invasive procedure with tiny incisions must be converted to an ‘open’ procedure with long incisions, possibly because of the patient’s anatomy or the skill level of the surgeon.

“Patients don’t want to be in any facility for long, and American patients mandated the outpatient fundoplication,” said Dr. Finley. “The surgery is so much less invasive, and also there is less risk, less pain and less recuperative time with a minimally-invasive procedure.”

“Ambulatory surgery centers are still being evaluated by insurance companies,” continued Dr. Finley. “We believe that studies like ours which prove the safety of the GERD procedure in an outpatient setting will help more patients get what they want from the healthcare system: procedures that are more efficient, more patient-friendly, and require less recuperative time,” he said.

America leads the world in outpatient surgery. “The Europeans found it amazing that we were sending patients home after 23 hours, not to a step-down unit or extended care facility. Their skill levels aren’t that different from ours; it’s their attitude toward outpatient surgery,” said Dr. Finley.