Outpatient Laparoscopic Surgery

Background : Outpatient laparoscopic surgery has been adopted by number of centres but an assessment of the patients' view of postoperative symptoms and satisfaction has not been reported. This study was undertaken to prospectively assess protocol for outpatient laparoscopic surgery established with the aims of minimizing postoperative symptoms and optimizing same–day discharge. Methods : Patients were considered appropriate for an outpatient laparoscopic procedure if they met the following criteria: if they were less than 70 years of age; if they were ASA category I or II; if they lived within 30 min of healthcare facility; and if they had an appropriate escort to accompany them on discharge and who would stay with the patient on the night after surgery. Clinical data were prospectively recorded. A telephone interview was carried out on the day after surgery to assess postoperative symptoms and patient satisfaction. Results : One hundred patients were planned for outpatient laparoscopic surgery (60 laparoscopic cholecystectomy, 36 laparoscopic groin hernia repair, and four miscellaneous); 95 of them were discharged on the day of surgery. The five patients remained in hospital because of surgical indications rather than complications of the anaesthetic. There were no readmissions on subsequent days. The telephone interview showed that pain was adequately controlled for 84% of patients, and that nausea (9%) and vomiting (4%) were uncommon. One hundred per cent of patients considered the anaesthetic and nursing care to be good or excellent, and 95% indicated they would have outpatient surgery for future similar procedure. Twenty‐nine per cent felt well enough to return to work on the second postoperative day. Conclusions : The success of this programme relates to patient selection and education, appropriate anaesthesia and defined anaesthetic and surgical protocol.