This has developed into a major clinical interest for the Center. Novel QoL study tools developed for this purpose have been refined and used extensively in an ongoing prospective study. The short and long-term outcome from other advanced videoendoscopic procedures is also being investigated. A recently published review of our experience with laparoscopic adrenalectomy is being expanded with longer term follow-up. We have also prospectively evaluated our experience with laparoscopic colectomy for efficacy in the subset of patients with severe ulcerative colitis undergoing total proctocolectomy and ileoanal J pouch formation.
Videoendoscopic technology is expensive.
This cost, and the potentially longer operative times have become a significant concern for wider application of advanced videoendoscopic techniques. To address these issues around a common disease process, a cost and human capital study comparing open and laparoscopic appendectomy at Harborview and UWMC is currently under development. Two other studies with similar goals have also been initiated. The first is intended to measure the time expended for resident education during routine laparoscopic cholecystectomy by detailed time analysis of procedures. The second is a micro-costing study of laparoscopic Nissen fundoplication, to supplement data collected over the past 3 years on the overall cost and resource utilization for laparoscopic treatment of gastroesophageal reflux.