STMO-14 Clinical experience of brain tumor surgery using middleware “OPeLiNK”

PURPOSE The removal of brain tumors requires not only imaging information such as MRI and navigation systems, but also a variety of other information such as neurological function and biological information. To integrate this information, a novel operating room, “Smart Cyber Operating Theater (SCOT)”, which connects the medical devices in the operating room via a network has developed. In this SCOT, the intraoperative information is time-synchronized, recorded, and stored by the middleware “OPeLiNK”. Clinical experience of brain tumor surgery using OPeLiNK in our institute is reported. Methods Brain tumor surgeries performed at SCOT, which had been started since July 2018, was enrolled. In all surgeries intraoperative information was integrated by OPeLiNK. Surgical procedure was discussed between main surgeon and supervising surgeon in the Strategy Desk through OPeLiNK intraoperatively, if necessary. Clinical and radiological data from patients who underwent resection at SCOT were analyzed retrospectively. Results Sixty patients were involved. Histopathological diagnosis was glioma in 29 patients, pituitary adenoma in 29 patients, acoustic tumor in 1 patient and intravascular lymphoma in 1 patient. Intraoperative discussion with Strategy Desk through OPeLiNK was useful for not only surgeons but also for medical staff in operation room. Advice for extent of resection and craniotomy from Strategy Desk was conducted by OPeLiNK using conversation and drawing. Intraoperative comment was useful for postoperative review. OPeLiNK, which display multiple intraoperative information, was also used at postoperative conference. Conclusion We have reported clinical experience with OPeLiNK for brain tumor surgery in our institute. OPeLiNK was useful for not only sharing intraoperative information with doctors outside the operation room but also postoperative review and education for young doctors.

A Modified Intrascleral Intraocular Lens Fixation Technique Using 27-Gauge Blunted Needles with Fewer Intraocular Manipulations

A new method for intraocular lens (IOL) fixation in the scleral tunnel using two common 27G blunted needles and an ultrathin 30G needle with fewer intraocular manipulations was developed. Half-depth scleral flaps were prepared, and vertically angled sclerotomies were performed under each scleral flap, 2 mm from the limbs with a 20G microblade or a 26G needle. Two bent 27G blunted needles connected the sclerotomy and corneoscleral incisions. One haptic was inserted into this bent 27G blunted needle extraocularly and extruded through the sclerotomy site. Each haptic was inserted into the lumen of the preplaced ultrathin 30G needle and buried into the scleral tunnel. In this retrospective study, we reviewed the outcomes of this new technique in patients with at least 3 months’ follow-up data. Iris capture of the IOL was not observed in any case, and IOL repositioning was not performed either. Astigmatism induced by intraocular aberration was almost as same as that with other methods. Our technique can be performed in any operation room without any extra instruments. This trial is registered with UMIN000044350.

Application of operation room optimization process with multidisciplinary collaborative management in hysteromyoma surgery

Objective: To explore the application of operation room optimization process with multidisciplinary collaborative management in hysteromyoma surgery. Methods: 500 patients who underwent hysteromyoma surgery from March to December 2018 were selected as the control group. 500 patients who underwent hysteromyoma surgery using operation room optimization process with multidisciplinary collaborative management from March to December 2019 were selected as the observation group. The scores of self-care ability (ESCA), psychological status (HAMA, HAMD score), time of postoperative early ambulation activity, comfort of ambulation activity, postoperative hospital stay and total hospital stay, postoperative complications, quality of life score (SF-36), satisfaction with care were compared between the two groups. Results: There was no significant difference in the scores of ESCA, HAMA and HAMD between the two groups before operation (P>0.05). On the 7th day after operation, the score of ESCA of tne two groups was increased (P <0.05), and that of the observation group was higher than that of the control group (P<0.05). The scores of HAMA and HAMD of the two groups were lower than that before operation (P<0.05) and that of the observation group was lower than that of the control group (P <0.05). The earliest time of postoperative ambulation activity of the observation group was earlier than that of the control group (P<0.05). Ambulation activity comfort was superior to the control group (P<0.05). The postoperative hospital stay and total hospital stay of patients in the observation group were shorter than that in the control group (P <0.05). There was no significant difference in preoperative SF-36 scores between the two groups (P>0.05). There was significant difference in SF-36 scores between the two groups after operation and after follow up for 3 months (P<0.05). The occurrence of adverse events in the observation group was lower than that in the control group (P<0.05). The satisfaction of nursing in the observation group was higher than that in the control group (P<0.05). Conclusion: The application of multidisciplinary collaborative management in hysteromyoma surgery can optimize the operation process, alleviate the patient's operation anxiety, promote the patient's postoperative rehabilitation, improve the patient's quality of lite and improve tne patients satisfaction, and therefore, it is worth popularizing.

CFD analysis of thermal comfort in hospital operation room with different air distribution design and operative temperature

The operation room is one of the most critical regions in hospital that require extra attention in air ventilation and prevention of dangerous pollutants contamination. A good level of ventilation will help to raise the productivity of workers in terms of performance and ensuring a safe surgery operation. It is obvious that today's operation rooms are completely equipped with mechanical ventilation systems. However, despite the fact that they meet the acceptable comfort standards, surgical workers have complained about thermal discomfort during operation which gives negative impact on their performance. Thermal comfort can be achieved by controlling the temperature, relative humidity and air movement. In this study, the operation room models are simulated to analyze the comfort conditions of surgical workers under 3 different air velocities at 0.2 ms-1, 0.25 ms-1 and 0.35 ms-1 and under 5 different temperatures between 16℃ to 20℃. Additionally, there are two 3D models created with different position of exhaust vent. The thermal comfort of surgical workers is measured using Predicted Mean Vote (PMV) and Predicted Percentage Dissatisfied (PPD) approaches using CBE Thermal Comfort Tool. The PMV and PPD results show that most surgical workers were outside the acceptable range value of -0.5 to +0.5 stated in ASHRAE Standard 55-2020. According to thermal scale index, most of the surgical workers were in a cool and slightly cool state despite the fact that the computational analysis shown an acceptable simulation validated with previous research studies. Finally, it has been discovered that clothing insulation, metabolic rate, mechanical equipment and air distribution design play a significant influence in providing comfort to the surgical workers.

Prevalence and Antimicrobial Resistance of Staphylococcus Species in Operation Room: Systematic Review and Meta-Analysis Protocol.

Background Pathogenic Staphylococcus species in routine medical care settings poses an increased risk of healthcare-associated infections that causes severe infections in humans and increased morbidity and mortality. These species are the most frequently transmitted infectious agents in the operating room that contributed to more than half of surgical site infections. Thus, this study aimed to estimate the global prevalence of staphylococcus species and their antimicrobial resistance profile in operating rooms of health care facilities. Methods Nine electronic databases including MEDLINE, Embase, Psych INFO, PubMed, Scopus, Web of Science, google scholar, Science Direct, and CINAHL will be used to collect the articles. To address the articles missed from the above databases, a direct search from google will be made. Similarly, the reference lists of the included articles will be searched manually. The search for the grey literature will be conducted using national or international repositories. Articles written in the English language, and conducted across the world that reported the prevalence of Staphylococcus species in the operating room will be included. Newcastle-Ottawa scale will be used to assess the quality of the included articles. The data will be extracted using Microsoft Excel 2016 and exported to STATA 16.0 software for the analyses. Pooled estimation of the outcome will be performed using DerSimonian-Laird random-effects model. Heterogeneity and publication bias of the studies will be presented with I2 statistics and funnel plots, respectively. Discussion Even though several studies laid out sources of microbial contamination as diverse and gram-positive bacteria is a common contaminant in the hospital setting, the prevalence and resistance profile of these contaminants in the operation room is not mentioned. This systematic review will provide evidence on the staphylococcus species in the operation room, the prevalence and antimicrobial resistance of each species. These findings will provide knowledge to clinicians on the level of contamination due to staphylococcus. Only studies published in English will be included and this may limit the current systematic review. Registration: Submitted to PROSPERO on 26/7/2021.

Knowledge and Practices on Risk Factors and Prevention of Varicose Vein among Operation Room Nurses of the Selected Hospitals

Lower-limb varicose veins (VVs) are frequent, and they're known to be more common in persons who work in jobs that require a lot of standing. Because nursing demands physical labour and lengthy periods of standing, women in this profession are at a higher risk of getting varicose veins. The aim of this study is to assess the knowledge and practices on risk factors and prevention of varicose vein among operation room nurses of the selected hospitals. A cross-sectional research design was used among registered nursing staff working in operation rooms of the selected hospitals. The convenient sampling technique was used to select fifty nurses. A structured pre-tested, validated tool was developed by the investigators to collect data from the nurses which include demographic as well as knowledge and practice variables of varicose veins. The findings of the present study show that 26% of nurses had inadequate knowledge and 14% of operation room nurses had poor practices. Also, there was a positive correlation between the knowledge and practice of nurses (r = 0.71). There was significant association for practice skills score with education and years of experience at p=0.05. The study concludes that to prevent occupational hazards in nursing, periodic health education and health promotion initiatives must be implemented.

1385 “Pre-Op Fasting Times Audit in Colorectal Surgery at A University Teaching Hospital”

Aim Hull University teaching hospitals NHS trust has guidelines for patient fasting times prior to major elective surgery. We aimed to assess the compliance of pre-op fasting times for patients undergoing elective colorectal surgery. Method An initial and later re-audit was undertaken, prospectively, of 20 consecutive patients admitted for elective colorectal surgery at Castle Hill Hospital. Data was collected on a structured proforma and was completed following patient’s interview, ORMIS (operation room system) and Lorenzo (hospital intranet). Results Initial audit demonstrated 10% (2 out of 20) and 5% (1 out of 20) compliance with liquid and solid fasting times, respectively. Following implementation of changes, re-audit demonstrated 60% (12 out of 20) and 0% (0 out of 20) compliance with liquid and solid fasting times respectively Conclusions We concluded that liquid fasting times can be improved further by communication between theatre staff and ward. Whilst solid fasting times can be improved but at an expense of losing a theatre space. A further re-audit [planned in a month period.