Interoperative efficiency in minimally invasive surgery suites.
BACKGROUND
Performing minimally invasive surgery (MIS) in a conventional operating room (OR) requires additional specialized equipment otherwise stored outside the OR. Before the procedure, the OR team must collect, prepare, and connect the equipment, then take it away afterward. These extra tasks pose a thread to OR efficiency and may lengthen turnover times. The dedicated MIS suite has permanently installed laparoscopic equipment that is operational on demand. This study presents two experiments that quantify the superior efficiency of the MIS suite in the interoperative period.


METHODS
Preoperative setup and postoperative breakdown times in the conventional OR and the MIS suite in an experimental setting and in daily practice were analyzed. In the experimental setting, randomly chosen OR teams simulated the setup and breakdown for a standard laparoscopic cholecystectomy (LC) and a complex laparoscopic sigmoid resection (LS). In the clinical setting, the interoperative period for 66 LCs randomly assigned to the conventional OR or the MIS suite were analyzed.


RESULTS
In the experimental setting, the setup and breakdown times were significantly shorter in the MIS suite. The difference between the two types of OR increased for the complex procedure: 2:41 min for the LC (p < 0.001) and 10:47 min for the LS (p < 0.001). In the clinical setting, the setup and breakdown times as a whole were not reduced in the MIS suite. Laparoscopic setup and breakdown times were significantly shorter in the MIS suite (mean difference, 5:39 min; p < 0.001).


CONCLUSIONS
Efficiency during the interoperative period is significantly improved in the MIS suite. The OR nurses' tasks are relieved, which may reduce mental and physical workload and improve job satisfaction and patient safety. Due to simultaneous tasks of other disciplines, an overall turnover time reduction could not be achieved.
van Det
M J
MJ
Department of Surgery, Leeuwarden Medical Center, P.O. Box 888, 8901 BR, Leeuwarden, The Netherlands. marc.van.det@znb.nl
Meijerink
W J H J
WJ
Hoff
C
C
Pierie
J P E N
JP
D017081:Cholecystectomy, Laparoscopic; D012809:Colon, Sigmoid / Q000601:surgery; D018592:Cross-Over Studies; D017598:Efficiency, Organizational; D006804:Ergonomics; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D009873:Operating Rooms / Q000458:organization & administration*