scholarly journals An Audit of Operating Room Time Utilization in a Teaching Hospital: Is There a Place for Improvement?

ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
George Stavrou ◽  
Stavros Panidis ◽  
John Tsouskas ◽  
Georgia Tsaousi ◽  
Katerina Kotzampassi
Keyword(s):  
Operating Room ◽  
Teaching Hospital ◽  
Interdisciplinary Collaboration ◽  
Anaesthesia Induction ◽  
Time Estimates ◽  
Time Usage ◽  
The Mean ◽  
Time Utilization ◽  
Duration Of Operation ◽  
Room Time

Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact P=0.000, which was less pronounced in the transfer to PACU/ICU P=0.006. Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration.

Benchmarks for the Durations of Ambulatory Surgical Procedures in Otolaryngology

2011 ◽  
Vol 120 (11) ◽  
pp. 727-731 ◽  
Author(s):  
Neil Bhattacharyya
Keyword(s):  
United States ◽  
Operating Room ◽  
Surgical Procedures ◽  
Ambulatory Surgery ◽  
Secondary Analysis ◽  
The United States ◽  
Tube Placement ◽  
The Mean ◽  
Room Time ◽  
Ambulatory Procedures

Objectives: I undertook to determine benchmarks and variability for the surgical times associated with ambulatory otolaryngological procedures in the United States. Methods: I examined the 2006 release of the National Survey of Ambulatory Surgery and extracted all cases of otolaryngological surgery in which one, and only one, otolaryngological procedure was performed. The mean surgical times and operating room times were determined for each procedure that met reliability criteria for their estimates. A secondary analysis was computed for tonsillectomy and for tonsillectomy plus adenoidectomy according to a patient age of greater than 12 years. Results: An estimated 1.68 ± 0.23 million otolaryngological procedures were analyzed as solitary procedures, including 507,000 cases of myringotomy with ventilation tube placement, 136,000 cases of tonsillectomy, and 429,000 cases of tonsillectomy plus adenoidectomy. The mean (±SE) surgical times were 8.0 ± 0.5, 23.9 ± 1.8, and 20.3 ± 0.8 minutes, respectively. The total operating room times were 17.6 ± 0.9, 48.2 ± 2.0, and 40.7 ± 1.1 minutes, respectively. Septoplasty with turbinectomy was the most common rhinologic procedure performed (48,000 cases analyzed) and had surgical and operating room times of 49.6 ± 4.78 and 79.8 ± 5.8 minutes, respectively. The surgical times for tonsillectomy and tonsillectomy plus adenoidectomy did not differ significantly in magnitude according to standard age cutoffs, although the operating room time was slightly (11.7 minutes) longer for tonsillectomy in patients more than 12 years of age (p = 0.034). Conclusions: The surgical times for the performance of the most common otolaryngological ambulatory procedures are remarkably consistent in the United States. Given the volume and consistency of these surgical procedures, they are ideal candidates for studies of cost and efficiency.

Effectiveness of adenotonsillectomy in improving of nocturnal enuresis in children with adenotonsillar hypertrophy

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Kassim R Dekhil ◽  
Ali abd-almer Jwad ◽  
Abbas Alyasiry
Keyword(s):  
Teaching Hospital ◽  
Nocturnal Enuresis ◽  
Adenotonsillar Hypertrophy ◽  
Number Of Children ◽  
The Mean ◽  
Childhood Condition ◽  
Rule Out

Nocturnal enuresis (NE) is an old & common childhood condition. It has been found that,there is a relationship between adenotonsillar hypertrophy in children & nocturnal enuresis. This study was conducted to see the effects of adenotonsillectomy on nocturnal enuresis in children with adenotonsillar hypertrophy.This study was conducted in Diwaniyah teaching hospital,Diwaniyah city,Iraq from May 2012 to August 2014. The total number of children admitted for adenotonsillectomy or tonsillectomy alone were 287. 76 children out of the total number were included in the study. The children were followed by the same questionnaire for four months postoperatively,including,age,the number of night bed wettings,type of enuresis and the results of urine examinationof total 287 children who were submitted for surgery,76 children were eligible for the study,48 (63.16%) of the total number included in the study were males and 28 (36.84%) were females. The mean age was 7.2 years. Adenotonsillectomy was performed in 64 children,and tonsillectomy in12 children. A complete improvement of nocturnal enuresis (NE) & daytime incontinence was achieved in 32 (42.11%) children. A mild to moderateimprovement was observed in 38 (50%),while no improvement seen in the remaining 6 (7.89%) children postoperatively.Nocturnal enuresis (NE) is an old & common childhood condition & there is a relation between nocturnal enuresis in children & adenotonsillar hypertrophy. Children with nocturnal enuresis should be evaluated by ENT surgeon to rule out any adenotonsillar hypertrophy for possible adenotonsillectomy effect. However,a wide base studies are needed to clarify these results.

scholarly journals Promising medium-term results of anterior approach with an anatomical short stem in primary hip arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fabrizio Rivera ◽  
Alessandro Bardelli ◽  
Andrea Giolitti
Keyword(s):  
Operating Room ◽  
Anterior Approach ◽  
Direct Anterior Approach ◽  
Short Stem ◽  
Medium Term ◽  
Operating Room Table ◽  
Sf 36 ◽  
Standard Operating ◽  
The Mean

Abstract Background In the last decade, the increase in the use of the direct anterior approach to the hip has contributed to the diffusion of the use of short stems in orthopedic surgery. The aim of the study is to verify the medium-term clinical and radiographic results of a cementless anatomic short stem in the anterior approach to the hip. We also want to verify whether the use of the standard operating room table or the leg positioner can affect the incidence of pre- and postoperative complications. Materials and methods All total hip arthroplasty patients with a 1-year minimum follow-up who were operated using the MiniMAX stem between January 2010 and December 2019 were included in this study. Clinical evaluation included the Harris Hip Score (HHS), Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC) Score, and Short Form-36 (SF-36) questionnaires. Bone resorption and remodeling, radiolucency, osteolysis, and cortical hypertrophy were analyzed in the postoperative radiograph and were related to the final follow-up radiographic results. Complications due to the use of the standard operating room table or the leg positioner were evaluated. Results A total of 227 patients (238 hips) were included in the study. Average age at time of surgery was 62 years (range 38–77 years). Mean follow-up time was 67.7 months (range 12–120 months). Kaplan–Meier survivorship analysis after 10 years revealed 98.2% survival rate with revision for loosening as endpoint. The mean preoperative and postoperative HHS were 38.35 and 94.2, respectively. The mean preoperative and postoperative WOMAC Scores were 82.4 and 16.8, respectively. SF-36 physical and mental scores averaged 36.8 and 42.4, respectively, before surgery and 72.4 and 76.2, respectively, at final follow-up. The radiographic change around the stem showed bone hypertrophy in 55 cases (23%) at zone 3. In total, 183 surgeries were performed via the direct anterior approach (DAA) on a standard operating room table, and 44 surgeries were performed on the AMIS mobile leg positioner. Comparison between the two patient groups did not reveal significant differences. Conclusion In conclusion, a short, anatomic, cementless femoral stem provided stable metaphyseal fixation in younger patients. Our clinical and radiographic results support the use of this short stem in the direct anterior approach. Level of evidence IV.

scholarly journals Functional and aesthetic outcomes of spreader graft and auto-spreader flap after nasal hump removal

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Maged Baher Naguib ◽  
Mohamed Rifaat Ahmed ◽  
Yasser Taha Madian ◽  
Tarek Mohamady Elnahriry ◽  
Wael Elshahat Eldeeb
Keyword(s):  
Nasal Obstruction ◽  
Operative Time ◽  
Nasal Valve ◽  
Spreader Graft ◽  
Spreader Flap ◽  
The Mean ◽  
The Difference ◽  
A New Technique ◽  
Nasal Valve Collapse ◽  
Duration Of Operation

Abstract Background Following the reduction of the nasal hump to a desired level, spreader grafts are usually positioned to prevent the complication of nasal valve collapse. Auto-spreader flap is a new technique that gained more popularity recently and can be used as an alternative to spreader graft. This RCCT compared between both techniques aesthetically and functionally as well as the operative time. Results Forty patients, 17 males (42.5%) and 23 females (57.5%), were included. The mean duration of operation in auto-spreader flap was 11.8 ± 3.4 min, while it was 19.2 ± 3.2 min in spreader graft. The difference between the two procedures was statistically significant (P < 0.05). Functional assessment of nasal obstruction was done for all patients in both groups preoperative that was (75.6 ± 19.9) which showed marked improvement when re-evaluated 3 moths postoperatively (18.9 ± 14.7), and after 6 months NOSE scale was (29.1 ± 20.2). The overall aesthetic satisfaction was 62.5% (25 of 40) irrespective of the surgery done. Sixteen out of 20 patients in spreader group and 9 out of 20 in auto-spreader flap group. Conclusion Auto-spreader flap and spreader graft are very effective surgical procedure for treatment of nasal obstruction due to internal nasal valve dysfunction, but the auto-spreader flap had shorter operative time. However, spreader graft has a superior aesthetic outcome.

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

2009 ◽  
Vol 23 (6) ◽  
pp. 939-943 ◽  
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

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

2011 ◽  
Vol 114 (2) ◽  
pp. 329-335 ◽  
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.

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

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