A comparison of operating room crowding between open and laparoscopic operations

Alarcón, Ana Gómez; Berguer, Ramón

doi:10.1007/bf00188483

Cited by 45 publications

(5 citation statements)

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“…Alarcon et al stated that laparoscopic surgery has a higher percentage of OR space occupied with instrumentation and results in multiple cables and tubes crossing the OR space perpendicularly, thereby impeding the circulation of personnel [49]. We did not observe a difference in complications between open and arthroscopic surgery.…”

Section: Discussioncontrasting

confidence: 55%

Fellows and Observers Are Not a Problem for Infection in the Operating Rooms of Teaching Centers

et al. 2021

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Purpose: The aim of the present study was to determine whether the risk of complications increases with the number of people in the operating room (OR). Several studies have stated that an increased number of people in the OR increases not only the risk of infection but also the risk of intraoperative complications due to distractions during the surgery. Materials and Methods: This retrospective study included all patients who had surgery between January 2017 and January 2018 in an OR with the usual surgical team and three or more observers. Patient demographic data, surgical details (duration of the surgery, the surgery being open or arthroscopic, and whether a graft was used), and intraoperative and postoperative complications were recorded. Results: A total of 165 surgeries were recorded, with a mean operating time of 70 min (40% open surgeries, 37% arthroscopic surgeries, and 23% combined open and arthroscopic procedures). The main intraoperative complications were vessel damage, nerve damage, premature cement setting, and leg-length discrepancy, with 1 case each. The main postoperative complications were rigidity (8 cases), unexplained pain (11 cases), failed meniscal suturing (3 cases), a postoperative stress fracture (1 case), correction loss in osteotomy (1 case), and wound problems not related to infection (1 case). There were no cases of infection. Discussion: The present study shows that the complication rate when having observers in the OR is comparable to the reported data. The key to avoiding complications is for everyone to comply with basic OR behavior.

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Section: Discussioncontrasting

confidence: 55%

Fellows and Observers Are Not a Problem for Infection in the Operating Rooms of Teaching Centers

et al. 2021

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“…This system facilitates versatile positioning of equipment as they are installed on columns attached to a ceiling-mounted suspension system. All the wiring is concealed inside the suspension system and led out through the ceiling which reduces operating room clutter and improves safety [ 4 , 24 ]. The CO2 gas, rather than utilising small canisters, is piped on demand thus reducing the time needed to change canisters and the resultant loss of a pneumoperitoneum that goes with loss of gass.…”

Section: Discussionmentioning

confidence: 99%

Gynaecologists’ and general surgeons’ preference for the features of integrated theatres: a discrete choice experiment

Morris

Cutner

2018

BMC Women's Health

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BackgroundLaparoscopic surgery is progressing rapidly is becoming the normal route for many abdominal operations, even for major complex surgery. The integrated laparoscopic theatre is a state-of-the-art system in which the laparoscopic equipment and multiple flat-screen monitors are permanently installed to be operational on demand inside the theatre. These expensive systems are being widely adopted, however very little research has been published regarding which features of these systems are desired by the surgeons who use them.The study objective was to assess the strength of preference for key attributes of integrated laparoscopic theatres and to compare these preferences between Gynaecologists and General surgeons.MethodsThis was an electronically distributed discrete choice experiment survey of British practicing Laparoscopic Gynaecologists and General Surgeons (Through The British Society of Gynaecology Endoscopy and The Association of Laparoscopic Surgeons of Great Britain and Ireland).An electronic survey was designed and pre-tested. This was then sent to practicing British Laparoscopic Gynaecologists and General-Surgeons. There were structured questions regarding the seven key attributes of integrated laparoscopic theatres in the standard form for a discrete choice experiment.ResultsQuestionnaires from 167 respondents were analysed. One hundred three were gynaecologists and 64 were general-surgeons. Adjustable screens for height and position was the most favoured attribute and it is 4.7 times more desirable than the next most desirable attribute, which was a wire free floor. The least desirable features were piped CO2, ceiling-mounted-screens and external-transmission-of-images.ConclusionBoth groups favour adjustable screens for position and height above all the other features. These findings are in contrast with previous research, which showed that when asked to rank the attributes in order, gynaecologists chose ceiling mounted screens first and adjustable screens fourth. When asked to “trade off” attributes in the discrete choice experiment the adjustability of the screens became much more important than how the screens were mounted. With new wireless technology the benefits of a fully integrated theatre could be delivered with floor mounted systems at a considerably reduced cost. This information is important to manufacturers and purchasers of these systems in order to design cost effective ergonomic theatres that are fit for purpose.Electronic supplementary materialThe online version of this article (10.1186/s12905-018-0576-2) contains supplementary material, which is available to authorized users.

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“…New technological innovations have made modern surgical practice safe; however, the equipment required in the modern OR also occupies a sizable amount of space. The laparoscopic arena is renowned to be more crowded than an open procedure, 6 but now that the cornerstone of laparoscopic instruments has been established, emerging technology has been directed toward minimizing their size and improving their ergonomics. The most widely accepted example of this modernization is the adoption of liquid crystal display (LCD) screens into the operative arena.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of a Cordless Laparoscopic Ultrasonic Device

Kim

Sehrt

Molina

et al. 2014

JSLS

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Objective:On April 25, 2012, the first laparoscopic cordless ultrasonic device (Sonicision, Covidien, Mansfield, Massachusetts) was used in a clinical setting. We describe our initial experience.Methods:The cordless device is assembled with a reusable battery and generator on a base hand-piece. It has a minimum and maximum power setting controlled by a single trigger for both coagulation and cutting. A laparoscopic radical nephrectomy was performed on a 56-year-old man with a 7-cm right renal mass. A laparoscopic pelvic lymphadenectomy was performed in a 51-year-old man with high-risk prostate cancer. Data on surgical team satisfaction, operative time, number of activations, and times the laparoscope was removed as a result of plume were collected.Results:The surgical technician successfully assembled the device at the beginning of the cases with verbal instructions from the surgeon. Operative time for nephrectomy was 77 minutes, with 143 total activations (minimum = 86, maximum = 57). The operative time for the pelvic lymphadenectomy was 27 minutes, with 38 total activations (minimum = 27, maximum = 11). One battery was used in each case. The laparoscope was removed twice during the nephrectomy and once during the lymphadenectomy. Surgical staff satisfaction survey results revealed easier and faster assembly, more space in the operating room, ergonomic handle, and comparable cutting/coagulation, weight, and plume generation with other devices (Table 1).Table 1.Survey of Operating Room StaffaEasy/YesDifficult/NoAbility to assemble the device7 (100%)0Ability to hand the device over to other members of the surgical team7 (100%)0Efficiency in saving space in the operating room7 (100%)0Overall satisfactionUnsatisfactoryIndifferentSatisfactory007 (100%)aOperating staff consisted of 4 surgeons and 3 scrub technicians and/or registered nurses.Conclusion:The first clinical application of the pioneering cordless dissector was successfully performed, resulting in surgeons' perceptions of comparable results with other devices of easier and safer use and faster assembly.

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A comparison of operating room crowding between open and laparoscopic operations

Abstract: We conclude that there is a significant trend toward increasing O.R. crowding during laparoscopic surgery. Innovative designs will be needed to reduce clutter in the O.R. of the future.

Cited by 45 publications

References 4 publications

Fellows and Observers Are Not a Problem for Infection in the Operating Rooms of Teaching Centers

Fellows and Observers Are Not a Problem for Infection in the Operating Rooms of Teaching Centers

Gynaecologists’ and general surgeons’ preference for the features of integrated theatres: a discrete choice experiment

Clinical Use of a Cordless Laparoscopic Ultrasonic Device

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