title: Dedicated minimally invasive surgery suites increase operating room efficiency.
abstract: BACKGROUND
  The rapid adoption of laparoscopic surgery since the late 1980s added tremendous complexity into the operating room (OR) environment. For each case, a plethora of additional equipment-including monitors, video equipment, wiring, tubing, and cords-had to be set up, prolonging OR turnover time and decreasing OR efficiency. In 1993, the concept of designated minimally invasive surgery (MIS) suites was introduced. MIS suites integrated monitors and video equipment into the OR on ceiling-mounted columns and moved the controls to a centralized nursing station. The overall effect of this innovation on OR efficiency has not been measured.
  
  
  METHODS
  Five RNs with varying degrees of MIS experience were instructed on video setup and put-away criteria and then timed while performing a set of standardized tasks. Each set of tasks was performed twice using a standardized surgery model. Differences in setup and put-away times between MIS suites and standard ORs were tested using the t-test for paired comparisons.
  
  
  RESULTS
  The mean +/- standard deviation (SD) video setup times were 27.9 +/- 5.3 sec (MIS) and 254.3 +/- 54.0 sec (standard); the put-away times were 19.8 +/- 2.7 sec (MIS) and 222.3 +/- 26.0 sec (standard). The mean difference +/- standard error (SE) in both the setup (226.4 +/- 16.9 sec, p = 0.0001) and put-away times (202.5 +/- 8.6, p = 0.0001) were large and statistically significant.
  
  
  CONCLUSIONS
  Using a simulation model, we have demonstrated that the use of a MIS suite reduces video setup and put-away time significantly, with the potential for significant associated cost savings. This provides just one justification for the high cost of building such "ORs of the future."
authors.affiliation: Department of Minimally Invasive Surgery, Legacy Health Systems, Emanuel Hospital, 2801 N. Gantenbein Ave., Portland, OR 97227, USA. tkenyon@lhs.org
authors.forename: T A
authors.initials: TA
authors.lastname: Kenyon
authors.forename: D R
authors.initials: DR
authors.lastname: Urbach
authors.forename: J B
authors.initials: JB
authors.lastname: Speer
authors.forename: B
authors.initials: B
authors.lastname: Waterman-Hukari
authors.forename: G F
authors.initials: GF
authors.lastname: Foraker
authors.forename: P D
authors.initials: PD
authors.lastname: Hansen
authors.forename: L L
authors.initials: LL
authors.lastname: Swanström
mesh_terms: D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D010535:Laparoscopy / Q000191:economics; D019060:Minimally Invasive Surgical Procedures / Q000191:economics; D009741:Nursing Staff, Hospital; D009873:Operating Rooms / Q000191:economics / Q000458:organization & administration; D013647:Task Performance and Analysis; D020535:Video-Assisted Surgery / Q000191:economics