Sanjoy Roy

Similar patient outcomes yet different hospital costs between flowable hemostatic agents

Abstract Introduction: SURGIFLO™ and FLOSEAL® are absorbable gelatin-based products that form hemostatic matrices. These products are indicated as adjuncts to hemostasis when control of bleeding by conventional surgical techniques (such as suture, ligature or cautery) is ineffective or impractical. This study analyzed the effect of surgery time and the choice of product on cost to the hospital and patient outcomes. Methods: The data source was the Premier Hospital database from January 1, 2010–June 30, 2012. Eligible patients were ≥18 years of age with a spinal fusion or refusion surgery with either SURGIFLO™ (Ethicon Inc.) or FLOSEAL® (Baxter International Inc.). The hospital Charge Master was used to identify the amount of flowable product, whether it included Thrombin, and the cost. Multivariable models were performed on overall cost and likelihood of surgical complications. All models were adjusted for patient demographics and severity as well as hospital, and surgical characteristics. Results: A total of 24,882 patient records from 121 hospitals were analysed, which included 15,088 FLOSEAL® records and 9794 SURGIFLO™ records, with 1498 SURGIFLO™ with Thrombin patients. Little or no differences in surgical complications were found between surgeries with SURGIFLO™ vs surgery with FLOSEAL®. Regression models showed a reduction in cost of

Comparison of economic and clinical outcomes between patients undergoing laparoscopic bariatric surgery with powered versus manual endoscopic surgical staplers

65 associated with use of SURGIFLO™ with Thrombin and an additional

Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colorectal Resection Surgery

21 reduction in hospital cost for each additional hour of surgery. Modeling which accounts for hospital fixed effects suggest that, in addition to a gap of ∼

Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

300 favoring SURGIFLO™ with Thrombin, every additional hour of surgery was associated with an additional reduction in hospital costs of ∼

The clinical and economic burden of significant bleeding during lung resection surgery: A retrospective matched cohort analysis of real-world data.

26. Conclusions: While the choice of flowable product had no effect on clinical outcomes, use of SURGIFLO™ was associated with hospital cost savings for flowable product. These savings increased with the length of surgery, even when controlling for the amount of flowable product (mL) used.

Systematic review of operative outcomes of robotic surgical procedures performed with endoscopic linear staplers or robotic staplers

Abstract Aims: To compare economic and clinical outcomes between patients undergoing laparoscopic Roux-en-Y gastric bypass (LRY) or laparoscopic sleeve gastrectomy (LSG) with use of powered vs manual endoscopic surgical staplers. Materials and methods: Patients (aged ≥21 years) who underwent LRY or LSG during a hospital admission (January 1, 2012–September 30, 2015) were identified from the Premier Perspective Hospital Database. Use of powered vs manual staplers was identified from hospital administrative billing records. Multivariable analyses were used to compare the following outcomes between the powered and manual stapler groups, adjusting for patient and hospital characteristics and hospital-level clustering: hospital length of stay (LOS), total hospital costs, medical/surgical supply costs, room and board costs, operating room costs, operating room time, discharge status, bleeding/transfusion during the hospital admission, and 30, 60, and 90-day all-cause readmissions. Results: The powered and manual stapler groups comprised 9,851 patients (mean age = 44.6 years; 79.3% female) and 21,558 patients (mean age = 45.0 years; 78.0% female), respectively. In the multivariable analyses, adjusted mean hospital LOS was 2.1 days for both the powered and manual stapler groups (p = .981). Adjusted mean total hospital costs (

Economic Impact of Laparoscopic Conversion to Open in Left Colon Resections

12,415 vs

Estimated Rate of Post-Operative Anastomotic Leak Following Colorectal Resection Surgery: A Systematic Review

13,547, p = .003), adjusted mean supply costs (

Assessment of the Psychometric Properties of the Short‐Form Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12) following Surgical Placement of Prolift+M: A Transvaginal Partially Absorbable Mesh System for the Treatment of Pelvic Organ Prolapse

4,629 vs

A Narrative of Intraoperative Staple Line Leaks and Bleeds During Bariatric Surgery

5,217, p = .011), and adjusted mean operating room costs (