Disparities between Operative Time and Relative Value Units for Plastic Surgery Procedures

2021 ◽  
Vol 148 (3) ◽  
pp. 638-644
Author(s):  
Jared A. Blau ◽  
Caitlin E. Marks ◽  
Brett T. Phillips ◽  
Scott T. Hollenbeck
2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Việt Hoa Nguyễn

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu ở trẻ em Phương pháp nghiên cứu: Nghiên cứu hồi cứu người bệnh phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu trong thời gian từ 1/1/2014 - 31/12/2017. Kết quả: Phẫu thuật nội soi sau phúc mạc cho 110 người bệnh trong đó hẹp khúc nối bể thận - niệu quản là 49 người bệnh (44,54%), thận niệu quản đôi 23 người bệnh (20,91%), thận đa nang 21 người bệnh (19,1%), thận teo mất chức năng 17 người bệnh (15,43%). Tuổi phẫu thuật trung bình là 4,5 ± 3,72 tuổi (từ 1 tuổi- 15 tuổi), tỉ lệ nam/ nữ = 3,3/1. Phẫu thuật nội soi cắt thận cho 52 người bệnh (47,27%), nội soi tạo hình cho 11 người bệnh (10%), nội soi hỗ trợ tạo hình cho 47 người bệnh (42,73%). Thời gian phẫu thuật trung bình 100 ± 20 phút. Thời gian nằm viện sau mổ trung bình là 3 ± 2,3 ngày. Không có biến chứng nặng. Kết quả theo dõi sau mổ 3- 36 tháng cho kết quả tốt 88%, trung bình 10%, xấu 2% Kết luận: Nội soi sau phúc mạc điều trị các bệnh lý thận, tiết niệu ở trẻ em là một phương pháp phẫu thuật an toàn, không có biến chứng, thẩm mỹ và cho kết quả tốt. Abstract Introduction: To evaluate the retroperitoneal laparoscopic surgery in children having the urinary anomalies Material and Methods: Retrospective study for children suffering from urinary anomalies underwent retroperitoneal laparoscopic surgery. Results: 110 children were operated by retroperitoneal laparoscopic approach included: 49 patients (44.54%) with ureter pelvic junction obstruction, 23 patients (20.91%) with ureteral duplication, 21 patients (19.1%) with multicystic dysplastic kidney, 17 patients (15.45%) with atrophy kidney. Mean age was 4.5± 3.72 years old (from 1 year to 15 years old); Gender ratio: male/female = 3.3/1. Laparoscopic nephrectomy for 52 cases (47.27%), 58 cases including 11 cases (10%) retroperitoneal laparoscopic pyeloplasty and 47 cases (42.27%) with assisted laparoscopic plastic surgery. Mean operative time was 100 ± 20 minutes, mean hospitalization length stay was 3 ± 2.3 days. No major complications occurred. Followed from 3 to 36 month are favorable with good outcome in 88%, average in 10%, poor in 2%. Conclusion: Retroperitoneal laparoscopic surgery is safe and feasible procedure in children with urinary anomalies. Keyword: Laparoscopic surgery; Retroperitoneal laparoscopic surgery; Urinary anomalies in children.


Author(s):  
Da David Jiang ◽  
Nicholas H Chakiryan ◽  
Kyle A Gillis ◽  
Ann Martinez Acevedo ◽  
Yiyi Chen ◽  
...  

2016 ◽  
Vol 2 (1) ◽  
pp. 9-19
Author(s):  
Abhishek Vijayakumar ◽  

Tourniquet is invaluable instrument to plastic, hand and orthopedic surgeon. It helps create a bloodless field for easy operation and reduces operative time. The advantages of tourniquet is no without its share of complication including nerve and skin injuries and devastating vascular lesions leading to amputation or death. A thorough understanding of the local and systemic effect of tourniquet is essential to minimize the complication. Various physical and pharmacological modifications reduce the reperfusion injury and also help increase tourniquet time. This review discusses the principle, physiology and complications of tourniquet. Keywords: Tourniquet, Limb occlusion pressure, Reperfusion injury, Nerve palsies, Limb protector sleeves.


Hand ◽  
2022 ◽  
pp. 155894472110643
Author(s):  
Trevor Simcox ◽  
Sakib Safi ◽  
Jacob Becker ◽  
Jason Kreinces ◽  
Adam Wilson

Background: This study aims to investigate whether compensation is equitable among the most commonly performed orthopedic hand surgeries and when compared with general orthopedic procedures. Methods: The National Surgical Quality Improvement Program database was queried for all orthopedic procedures, from 2016 to 2018, performed more than 150 times using Current Procedural Terminology (CPT) codes. Physician work relative value unit (wRVU) data were obtained from the 2020 US Centers for Medicare and Medicaid Services fee schedule. Linear regressions were used to determine whether there was an association among wRVU, operative time, and wRVU per hour (wRVU/h). Reimbursement for hand surgery CPT codes was compared with that of nonhand orthopedic CPT codes. The CPT codes were stratified into quartile cohorts based on mean operative time, major complication rate, mortality rate, American Society of Anesthesiologists class, reoperation rate, and readmission rate. Student t tests were used to compare wRVU/h between cohorts. Results: Forty-two hand CPT codes were identified from 214 orthopedic CPT codes, accounting for 32 333 hand procedures. The median wRVU/h was significantly lower for procedures in the longest operative time quartile compared with the shortest operative time quartile ( P < .001). Compared with hand procedures, nonhand procedures were found to have significantly higher mean operative time ( P < .001), mean complication rate ( P < .001), mean wRVU ( P = .001), and mean wRVU/h ( P = .007). Conclusions: The 2020 Physician wRVU scale does not allocate proportional wRVUs to orthopedic hand procedures with longer mean operative times. There is a decrease in mean reimbursement rate for hand procedures with longer mean operative time. When compared with general orthopedic procedures, hand procedures have a lower mean wRVU/h and complication rate.


2020 ◽  
Author(s):  
Gregory L. Barinsky ◽  
David W. Wassef ◽  
Roman Povolotskiy ◽  
Jordon G. Grube ◽  
Wayne D. Hsueh ◽  
...  

2019 ◽  
Vol 229 (4) ◽  
pp. S317-S318
Author(s):  
Solomon Hayon ◽  
Allison Deal ◽  
Hung-Jui Tan ◽  
Brooke Namboodri ◽  
Case Wood ◽  
...  

Author(s):  
Suresh K. Nayar ◽  
Keith T. Aziz ◽  
Dawn M. LaPorte ◽  
Ryan Zimmerman ◽  
Uma Srikumaran ◽  
...  

2010 ◽  
Vol 3 (4) ◽  
pp. 231-235 ◽  
Author(s):  
Jorge Ciechomski ◽  
Ruben Aufgang ◽  
Lucrecia Villanueva ◽  
Victoria Demarchi

We report our experience with the subcranial approach, developed at the Plastic Surgery Unit of Hospital “Ricardo Gutiérrez,” for the treatment of injuries in the frontoethmoidal orbital region in pediatric patients. The subcranial approach was described by Raveh et al for the treatment of fractures in the frontoethmoidal area. The subcranial approach was used later for surgery of tumors and deformities of the frontoethmoidal region. We have used this approach in nine cases of nontraumatic injuries (one meningioma, one orbital bone fibrous dysplasia, one vascular malformation, five nasal dermoid cysts, and one fronto-orbital mucocele). One patient with vascular malformation died of a stroke 10 days after surgery. The patient with the meningioma had a recurrence. Another patient developed an infection that needed surgical resolution and hardware removal. A third patient suffered a mild infection that receded with medication. No other complications were registered. The surgical exposure obtained through this approach was always excellent and left no cosmetic defects. There was no evidence of facial growth disturbance in this group of patients, except in one patient who received radiotherapy after surgery. Operative time and hospitalization were lower in this group than in patients with conventional frontal craniotomy.


2019 ◽  
Vol 154 ◽  
pp. 14
Author(s):  
S. Uppal ◽  
E.L. Barber ◽  
R.K. Reynolds ◽  
L.W. Rice ◽  
R.J. Spencer

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