Pennsylvania Bans Access to Gallbladder Surgery at Safe and Affordable Ambulatory Surgery Facilities

ALEXANDRIA, Va. -- The Pennsylvania Department of Health issued a notice that will erect a roadblock in the path of consumers wanting a safe, affordable place to have outpatient gallbladder surgery.  The notice prohibits ambulatory surgery centers (ASCs) from performing some laparoscopic procedures, such as a procedure known as laparoscopic cholecystectomy for the removal of gall stones.  Laparoscopic procedures are less intrusive ways of performing many surgical procedures.

Laparoscopic cholecystectomy (lap chole) has been performed effectively and safely in ambulatory surgery facilities since they were first introduced into the United States 16 years ago.  In fact, the first lap chole performed in the nation was in an ambulatory surgery center.  Since that time, a growing number of patients have sought the treatment of gall stones in ambulatory surgery facilities.  The Federated Ambulatory Surgery Association (FASA), the nation’s largest association of ASCs, estimates that as many as 44,000 laparoscopic cholecystectomies may have been performed in surgery centers in 2003 alone.  FASA data also reveals that ASCs have an excellent safety record with these procedures, with about 99 percent performed free of complications.

Ambulatory surgery centers are safe, cost-effective and patient-friendly facilities that offer patients a better way to have outpatient surgery.  Seventy percent of all surgeries in America are outpatient and one out of every five of these is performed in an ASC.

“Denying patients access to these procedures in Pennsylvania’s outpatient surgery facilities is bad medicine,” said FASA’s executive vice president Kathy Bryant.  “The Department of Health’s decision will harm patients by denying them access to a safe, affordable and friendly facility for the treatment of a painful disease.  It will also drive up costs because gallbladder surgery, like most other procedures, usually costs less when performed at an ASC than at a hospital.”

During a lap chole, instruments, a light and camera are passed through several small incisions in the abdomen and the surgeon can view inside a

patient’s stomach by looking at a video monitor.  A lap chole does not require

the abdominal muscles to be cut, resulting in less pain, quicker healing, less

scarring and fewer complications such as infection.  The average procedure

takes about an hour; the patient recovers in an ASC for a few hours, followed

by a few days rest at home.

FASA said the Department’s notice is especially troubling because of its lack of clarity in defining procedures that can no longer be performed in ASCs.  Bryant also said that the Department is rejecting widely held medical opinion of what is considered “minimally invasive” versus “major invasion” surgery.  It says that “most invasions of abdominal or thoracic cavities are major invasions,” but has provided no explanation for its determination that some laparoscopic surgeries are major.  Following the posting of this notice, FASA is evaluating options now available and working with its members to determine how many patients will be affected by this decision.

The Federated Ambulatory Surgery Association, the nation’s largest association of ambulatory surgery centers, is a national, nonprofit association that represents the interests of those who operate and seek the services of ambulatory surgery centers throughout the nation.  The organization represents 1,400 ASCs, the thousands of professionals who provide care and services in such centers and the patients who seek care there.  Visit FASA online at http://www.fasa.org.

SOURCE: Federated Ambulatory Surgery Association

Share this article: Email, Slashdot, Digg, Del.icio.us, Yahoo!MyWeb, Windows Live Favorites, Furl
Add this article feed to: RSS, My Yahoo, Newsgator, Bloglines