National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011 Anita Krishnan 1

Ambulatory ENT Surgery

Dr.Anita Krishnan DLO (AFMC), DNB , DMLE

Consultant ENT Head and Neck Surgeon Nova Medical Centers Pvt Ltd

Agenda

Analysis of ENT surgeries from July 2009- August 2011 at Nova Medical center , Koramangala(Personal Experience of 220 surgeries )

Complications occurred

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Introduction

Almost 2 million ENT cases per year in UK

NHS is done as Daycare .

More than 50% ENT Surgeries in U.S over the

last 4 decades is done as Daycare .

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U.S Statistics Nova Medical Centers

8% of Total case

volume in ambulatory

standalone centers is

ENT

Average Gross charge

per case is 7066$

Average Net Revenue

per case is 1742$

6.53% of total case

volume .

Average Gross charge

per case is Rs.17975 (

450$ )

Surgical Log

Nasal Surgeries

Septoplasty -49

Functional Endoscopic Sinus Surgery -35

Turbinoplasty-20

Laser Assisted Turbinoplasty -13

Septo Rhinoplasty -4

Foreign Body Nose-3

Endoscopic Cautery for Epistaxes-2

Nasal Bone Fracture Reduction - 3

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Surgical Log

Ear Surgeries

Tympanoplasty -14

Mastoidectomy -12

Myringotomy and Gromet -9

Stapedectomy -1

Foreign Body removal Ear -1

Pre auricular Sinus Excision -2

Myringotomy and Gromet -9

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Breaking Boundaries

Laser Assisted Tonsillectomy

Uvuloplatopharyngoplasty and Septoplasty

was performed in a single sitting .

Superficial Parotidectomy

So What is Possible !

What is Suitable !

What is Prohibited !

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Complications Occurred

3 of 220 surgical cases (1.2%)

Case 1

Post Adenoidectomy bleeding which was controlled with post nasal packing for 24hrs.

Case 2

Post Adenotonsillectomy Laryngo-bronchospasm probably due to thick secretions and the child was shifted to Apollo Hospitals ,where he recovered with racemic adrenaline nebulisation , and conservative management .

Case 3

Post Turbinectomy epistaxes which was managed with post nasal packing . Patient was shifted out to major hospital where he was observed for 72 hrs and pack was removed uneventfully after 72 hrs.

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Why NOVA ?

Caring attentive staff

Consistency in Operating assistants

Respect and value for everyone’s time.

Very few last minute cancellations .

State of the art instruments.

Lack of fear factor

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What I learnt ?

Communication is the key

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Thank you !