Outpatient Surgery Magazine

Is Your Data Secure? Subscribe to Outpatient Surgery Magazine - November 2017

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 1 may free up another highly skilled surgeon. Also, most patients look at robotics as a sign that a facility invests in its surgical pro- gram. This, in turn, might attract patients — even if they're not candidates for robotics-assisted surgery — and elite surgeons eager to use the system. Of course, robotics is no cure-all. Bear in mind that the initial cost of the robot is significant — upwards of $1 million — and, in general, the cost of a robotic hernia repair will exceed that of either a traditional or laparoscopic hernia repair. — Mark A. Reiner, MD To me, the right mesh-fixation option will balance 3 primary factors: how easy it is to use; how effectively it integrates the mesh with sur- rounding tissue; and how much it costs. I find using 1 or 2 tacks to be quite feasible from a cost perspective, and it's also often the quickest and easiest option for getting the mesh fixated early, so patients can get back to their routine within a few days of surgery. A word of caution for less experienced surgeons: Don't assume that something provides superior fixation just because it costs more. No sur- geon wants to encounter a problem, so there may be a temptation to hedge your bets by opting for the "best" (read: most expensive) option. But chances are that once you've gotten a good result with a certain device or technique, you'll never want to change. That's why you may want to develop proficiency in multiple modes of fixation, including those that can help you keep costs down without compromising patient safety. A high-end biologic mesh could easily double your case costs, compared with a synthetic polypropylene mesh, so you have to save wherever you can in order to preserve your profit margin. OSM Dr. Reiner (mdreiner@aol.com) is a general surgeon at Mount Sinai Hospital in New York City, as well as a professor in general surgery, obstetrics, gynecology and reproductive medicine at Icahn School of Medicine at Mount Sinai Health System.

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