1. Ambulatory ENT Surgery
Dr.Anita Krishnan
DLO (AFMC), DNB , DMLE
Consultant ENT Head and Neck Surgeon
Nova Medical Centers Pvt Ltd
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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

2. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

3. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

4. U.S Statistics Nova Medical Centers
8% of Total case 6.53% of total case
volume in ambulatory volume .
standalone centers is
ENT Average Gross charge
per case is Rs.17975 (
Average Gross charge 450$ )
per case is 7066$
Average Net Revenue
per case is 1742$
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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

5. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

6. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

7. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

8. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

9. 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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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

10. What I learnt ?
Communication is the key
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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011

11. Thank you !
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Anita Krishnan National Conference Ambulatory Surgery, Sept 2001, Bangalore 2011