The impact of BMI on operating room time, blood loss, and hospital stay in patients undergoing spinal fusion

Abstract Background Video-assisted thoracoscopic surgery (VATS) has become the preferred approach for minimizing harm from thoracic operations. There is no report, however, which has discussed the feasibility of VATS in ipsilateral reoperation of major lung resection. Methods The present study included patients who had undergone ipsilateral reoperation of major lung resection by VATS from October 2009 to May 2017. Referring clinical data were recruited for analysis. Results Fourteen patients were recruited in the present study, including nine patients who underwent lobectomy and five who underwent segmentectomy during the second operation. Different hila were found in 6 patients, and pleural adhesions appeared in 10 patients. The average intraoperative blood loss was 203.6 ± 121.7 mL, and the mean operating room time was 2.2 ± 0.5 hours. There were no intraoperative deaths, and only one patient required conversion to thoracotomy. The average drainage time was 5.9 ± 4.6, and the mean hospital stay was 6.7 ± 4.2 days. Conclusion Though it is technically demanding to safely handle the changed hilum structure caused by the last operation, major lung resection by VATS is feasible for ipsilateral reoperation in appropriate candidates.

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Impact of Urinary Catheterization on Postoperative Outcomes After Roux-En-Y Gastric Bypass Surgery in Propensity-Matched Cohorts

The American Surgeon ◽

10.1177/00031348211023444 ◽

2021 ◽

pp. 000313482110234

Author(s):

Derek D. Berglund ◽

David M. Parker ◽

Marcus Fluck ◽

James Dove ◽

Alexandra Falvo ◽

...

Keyword(s):

Gastric Bypass ◽

Operating Room ◽

Urinary Catheter ◽

Postoperative Outcomes ◽

Urinary Catheters ◽

Readmission Rates ◽

Delayed Discharge ◽

The Impact ◽

Room Time ◽

Operating Room Time

Background The impact of urinary catheter avoidance in bariatric enhanced recovery after surgery (ERAS) protocols is yet to be established. The purpose of the current study is to determine whether urinary catheter use in patients undergoing Roux-en-Y gastric bypass (RYGB) procedures has an effect on postoperative outcomes. Methods An institutional database was utilized to identify adult patients undergoing primary minimally invasive RYGB surgery. Outcomes included incidence of urinary tract infection (UTI) within 30 days postoperatively, 30-day readmission rates, proportion of patients discharged after postoperative day 1 (delayed discharge), length of stay (LOS), and operating room time. These were compared between propensity-matched groups with and without urinary catheter placement. Results There were no significant differences in postoperative UTI’s (2.2% for both cohorts, P = .593) or 30-day readmission rates for patients with and without urinary catheters (6.6% and 4.4%, respectively, P = .260). Mean LOS (1.7 vs. 1.5 days, P = .001) and the proportion of patients having a delayed discharge (47.3% vs. 33.7%, P = .001) was greater in patients with a catheter. Operating room time was longer in the urinary catheter group (221.8 vs. 207.9 minutes, P = .002). Discussion Avoidance of indwelling urinary catheters in RYGB surgical patients decreased delayed discharges and LOS without affecting readmission or reoperation rates. Therefore, we recommend that avoidance of urinary catheters in routine RYGB surgery be considered for inclusion into standardized ERAS protocols. Urinary catheters should continue to be utilized in select cases, however, as these were not shown to affect rate of UTIs.

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From Classroom to Operating Room, Time Management Matters

Biomedical Instrumentation & Technology ◽

10.2345/0899-8205(2007)41[201:fctort]2.0.co;2 ◽

2007 ◽

Vol 41 (3) ◽

pp. 201-203

Author(s):

Charles Taylor

Keyword(s):

Operating Room ◽

Time Management ◽

Room Time ◽

Operating Room Time

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PSU18 Exploring Cumulative SUM (CUSUM) As a Method to Evaluate Change in Operating Room Time in the Initial Cases of a Surgeon Using Robotic Assisted Surgery (RAS)

Value in Health ◽

10.1016/j.jval.2021.04.1137 ◽

2021 ◽

Vol 24 ◽

pp. S227

Author(s):

D. D'Attilio ◽

C. Lorkowski ◽

U. Kreaden

Keyword(s):

Operating Room ◽

Cumulative Sum ◽

Robotic Assisted ◽

Robotic Assisted Surgery ◽

Room Time ◽

Operating Room Time

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Is Robot Assistance Affecting Operating Room Time Compared with Pure Retroperitoneal Laparoscopic Radical Prostatectomy?

Journal of Endourology ◽

10.1089/end.2008.0521 ◽

2009 ◽

Vol 23 (6) ◽

pp. 939-943 ◽

Cited By ~ 20

Author(s):

Guillaume Ploussard ◽

Evanguelos Xylinas ◽

Alexandre Paul ◽

Norman Gillion ◽

Laurent Salomon ◽

...

Keyword(s):

Radical Prostatectomy ◽

Operating Room ◽

Laparoscopic Radical Prostatectomy ◽

Robot Assistance ◽

Room Time ◽

Operating Room Time

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Intraoperative computed tomography registration and electromagnetic neuronavigation for transsphenoidal pituitary surgery: accuracy and time effectiveness

Journal of Neurosurgery ◽

10.3171/2010.5.jns091821 ◽

2011 ◽

Vol 114 (2) ◽

pp. 329-335 ◽

Cited By ~ 22

Author(s):

Paula Eboli ◽

Bob Shafa ◽

Marc Mayberg

Keyword(s):

Mr Imaging ◽

Operating Room ◽

Navigation System ◽

Surgical Techniques ◽

Imaging Data ◽

3D Navigation ◽

Closure Time ◽

Bony Landmarks ◽

Room Time ◽

Operating Room Time

Object The authors assessed the feasibility, anatomical accuracy, and cost effectiveness of frameless electromagnetic (EM) neuronavigation in conjunction with portable intraoperative CT (iCT) registration for transsphenoidal adenomectomy (TSA). Methods A prospective database was established for data obtained in 208 consecutive patients who underwent TSA in which the iCT/EM navigation technique was used. Data were compared with those acquired in a retrospective cohort of 65 consecutive patients in whom fluoroscope-assisted TSA had been performed by the same surgeon. All patients in both groups underwent transnasal removal of pituitary adenomas or neuroepithelial cysts, using identical surgical techniques with an operating microscope. In the iCT/EM technique–treated cases, a portable iCT scan was obtained immediately prior to surgery for registration to the EM navigation system, which did not require rigid head fixation. Preexisting (nonnavigation protocol) MR imaging studies were fused with the iCT scans to enable 3D navigation based on MR imaging data. The accuracy of the navigation system was determined in the first 50 iCT/EM cases by visual concordance of the navigation probe location to 5 preselected bony landmarks. For all patients in both cohorts, total operating room time, incision-to-closure time, and relative costs of imaging and surgical procedures were determined from hospital records. Results In every case, iCT registration was successful and preoperative MR images were fused to iCT scans without affecting navigation accuracy. There was 100% concordance between probe tip location and predetermined bony loci in the first 50 cases involving the iCT/EM technique. Total operating room time was significantly less in the iCT/EM cases (mean 108.9 ± 24.3 minutes [208 patients]) compared with the fluoroscopy group (mean 121.1 ± 30.7 minutes [65 patients]; p < 0.001). Similarly, incision-to-closure time was significantly less for the iCT/EM cases (mean 61.3 ± 18.2 minutes) than for the fluoroscopy cases (mean 71.75 ± 19.0 minutes; p < 0.001). Relative overall costs for iCT/EM technique and intraoperative C-arm fluoroscopy were comparable; increased costs for navigation equipment were offset by savings in operating room costs for shorter procedures. Conclusions The use of iCT/MR imaging–guided neuronavigation for transsphenoidal surgery is a time-effective, cost-efficient, safe, and technically beneficial technique.

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Blood, Sweat, Toil, and Tears of Surgical Training. Part I: Blood

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230701500408 ◽

2007 ◽

Vol 15 (4) ◽

pp. 307-309 ◽

Cited By ~ 2

Author(s):

Andrew J Drain ◽

Jonathon I Ferguson ◽

Sharon Wilkinson ◽

Samer AM Nashef

Keyword(s):

Adverse Effect ◽

Blood Loss ◽

Operating Room ◽

Clinical Outcomes ◽

Surgical Training ◽

Clinical Service ◽

Significant Difference ◽

Potential Impact ◽

The Impact ◽

Cardiac Operations

There may be conflict between the requirements of surgical training and those of the clinical service if training has an impact on clinical outcomes. One area of potential impact is perioperative blood loss. We compared total and 12-hour blood loss after 2,079 consecutive cardiac operations performed over 2 years by trainees and consultants. One- and two-way analyses of variance with EuroSCORE and surgeon status as factors were carried out to evaluate the impact of surgeon status on blood loss. There was no difference in blood loss between consultants and trainees. We also compared the rates between consultants and trainees of patients returning to the operating room due to bleeding. This showed a significant difference, with trainees having a higher rate of investigation for bleeding. Cardiac surgical training can be achieved without an adverse effect on blood loss, but it may be associated with a higher rate of re-intervention for bleeding.

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