MINIMALLY INVASIVE SURGERY (MIS) PERSPECTIVES

An article from the Insights Series

pdf Small Incision, Big Impact. How Minimally Invasive Surgery Improves Outcomes (.pdf)

Article details how positive change occurs when patients have access to minimally invasive surgery (MIS), and how best practices to adopt MIS provide a compelling — and necessary — path forward.

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Open surgery remains the standard of care around the world — but that needs to change.

"Minimally invasive surgery (MIS) is a far better option in many cases."

Relative to MIS, open-surgery patients can experience higher rates of costly complications, longer hospital stays, increased blood loss, and higher readmittance rates.1–3 Everyone — patients, payers, and clinicians — end up paying more for less optimal outcomes.

Minimally Invasive Surgery Technique

ECONOMIC AND CLINICAL VALUE OFFERED BY MIS

MIS significantly improves outcomes at a lower overall cost.1 A budget-impact model study performed by Milliman actuarial staff looked at 46,386 surgical cases from a commercial payer perspective and found:

  • $12,989 savings for MIS thoracic resection4
  • $10,204 savings for MIS colectomy4
  • $3,721 savings for MIS ventral hernia repair 4
  • $1,174 savings for MIS non-cancer hysterectomy4

From a clinical standpoint, various peer-reviewed studies across surgical specialties have compared outcomes of open surgery to MIS. Open-surgery patients were reported as being hospitalized for 7.4 days, while laparoscopic and thoracoscopic patients were discharged after only 4.5 days. As a result, the total procedural and hospitalization costs of care for minimally-invasive approaches were $7,405, or 23% less on average.4

A recent study in JAMA Surgery advocates that MIS approaches offer compelling near-term and long-term cost savings for the healthcare system and less trauma for patients.5

IMMERSIVE SURGICAL TRAINING KEY TO INCREASED MIS ADOPTION

The primary barrier to widespread MIS adoption is the lack of opportunities for surgeon training.

Deborah Keller M.D., a colorectal surgeon at Colorectal Surgical Associates, explains. "There is a learning curve, especially given the time commitment to learn the procedures.”

To overcome that learning curve, we believe it’s essential to employ training best practices that include a hands-on approach in a clinical setting.  Immersive training — using a “hub and spoke” model  — enables scalability within large hospital systems and, more importantly, helps smaller hospitals and geographically isolated hospitals access MIS.

Increased utilization of MIS globally has the potential to improve outcomes and lower costs, benefitting healthcare systems and millions of patients around the world.

1

Dimick JB, Chen SL, Taheri PA, Henderson WG, Khuri SF, Campbell DA Jr. Hospital costs associated with surgical complications: a report from the private-sector National Surgical Quality Improvement Program. J AmColl Surg. 2004;199(4):531-537.

2

Tiwari MM, Reynoso JF, High R, Tsang AW, Oleynikov D. Safety, efficacy, and cost effectiveness of common laparoscopic procedures. Surg Endosc. 2011;25(4):1127-1135.

3

Biondi A, Grosso G, Mistretta A. Laparoscopic-assisted versus open surgery for colorectal cancer: short- and long-term outcomes comparison. J Laparoendosc Adv Surg Tech. 2013;23(1):1–7.

4

Fitch K, Engel T, Bochner A. Cost differences between open and minimally invasive surgery. Managed Care. 2015;24(9):40–48.

5

Crawshaw BP, Chien H, Augestad KM, Delaney CP. Effect of Laparoscopic Surgery on Health Care Utilization and Costs in Patients Who Undergo Colectomy. JAMA Surg. 2015;150(5):410–415. oi:10.1001/jamasurg.2014.

Bob White

Bob White

 

Bob White is Executive Vice President and President, Minimally Invasive Therapies Group. Previously, he served as President, Emerging Markets, President, Respiratory and Monitoring Solutions, and Vice President and General Manager of Patient Monitoring at Covidien. He also held leadership positions at GE Healthcare and IBM. A Fellow of the American College of Healthcare Executives (FACHE), he was also formerly on the boards of the Asia Pacific Medical Technology Association (APACMed), the US-ASEAN Business Council, the Anesthesia Patient Safety Foundation (APSF), and the National Patient Safety Foundation (NPSF).

Bob's paper outlining the benefits of minimally invasive surgery was recently featured in Modern Healthcare.