Laparoscopic appendectomy

A laparoscopic approach to acute appendicitis has been recommended by SASES.

The benefits of the laparoscopic approach are obvious to any laparoscopic surgeon and include:

  • Shortened hospital stay
  • Faster return to work and normal activities
  • Reduced risk of would sepsis
  • Improved ability to confirm the diagnosis and locate the appendix
  • Ability to treat other intra-abdominal pathology immediately, without additional incisions
  • Reduced post operative pain
  • Smaller incisions with better cosmetic results
  • Ideal training operation for surgeons trying to improve laparoscopic skills

These advantages have resulted in greater patient demand for the laparoscopic approach.

The disadvantage is potentially higher cost.

If the surgeon is careful about his choice of expensive disposable items, these costs can be minimised. Cost drivers have been discussed and a list of acceptable intruments are available on the website.

A consensus document on appendectomy is available on the site.

 

Acute appendicitis is a prescribed minimum benefit condition and should therefore be fully funded by medical aid companies.

This funding should include costs related to diagnosis, surgery and post op care. Surgery covered should include laparoscopic or open appendectomy.

Medical insurance companies often attempt to use the loophole that laparoscopic appendectomy is not "standard of care" of their appointed designated service providers or state hospitals.

Letters from surgeons at a number of state hospitals are available for download. All confirm that laparoscopic appendectomy is regarded as standard of care within those institutions. 

However surgeons should not excessively inflate their charges for PMB conditions. This will result in medical aids fighting back with everything they can to avoid funding PMB conditions. This ultimately affects all surgeons. Please charge the same rates whether PMB or not.

Surgeons should also be aware of the cost implications of their choices of disposables in theatre. Do not allow staff to routinely open expensive disposable items that may not even be required. 

 

 

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