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

Open versus robot-assisted radical prostatectomy: A contemporary analysis of an all-payer discharge database.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 33-33
Author(s):  
Jeffrey J. Leow ◽  
Quoc-Dien Trinh ◽  
Benjamin I. Chung ◽  
Steven L. Chang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Operating Room ◽  
Hospital Costs ◽  
Blood Products ◽  
Robot Assisted ◽  
The Us ◽  
Discharge Database ◽  
Room Time ◽  
Operating Room Time

33 Background: Robot-assisted radical prostatectomy (RARP) has been rapidly adopted in the US despite the lack of Level 1 evidence. There is no conclusive evidence regarding its morbidity profile compared to open RP (ORP). Our aim was to compare perioperative outcomes of RARP vs. ORP on a contemporary cohort of patients. Methods: Using the Premier Hospital Database, an all-payer discharge database representing over 600 hospitals in the US, we captured men diagnosed with prostate cancer (ICD-9 code 185) who underwent a radical prostatectomy (60.5) from 2003 to 2013.We classified procedures as RARP through a review of the charge description master by identifying supplies unique to robotic procedures. We evaluated 90-day postoperative complications (using Clavien classification), transfusion of blood products, operating room time, length of stay and direct hospital costs. We performed regression analyses, adjusting for potential confounders, accounting for clustering by hospitals and survey weighting to ensure nationally representative estimates. Results: Over the 11-year study period, there was a total of 345,313 ORP and 328,731 RARP. The use of RARP grew rapidly from 2% in 2003 to 85% in 2013 (p<0.001). On adjusted analyses, compared to ORP, RARP patients were less likely to suffer major complications (odds ratio [OR] 0.77, p=0.03), readmissions (OR 0.81, p=0.02), or receive blood products (OR 0.28, p<0.001). RARP patients had shorter LOS (-0.88 days, p<0.001). Mean operating room time for RARP was longer by 71 min (p<0.001); higher surgeon and hospital volume were significant predictors of shorter operating time. 90-day direct hospital costs were higher for RARP (+$4085, p<0.001), primarily attributed to operating room and supplies costs. Conclusions: Our contemporary analysis of men who underwent RP found that the robotic approach appears to confer a perioperative morbidity advantage at a higher cost. The widespread adoption of RARP in the management of localized prostate cancer implies a randomized trial will unlikely be conducted; therefore this large retrospective study may represent the best available evidence for the morbidity and cost profile of ORP vs. RARP.

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.

Operating Room Management in Health Care

2015 ◽  
pp. 847-867
Author(s):  
Irem Ozkarahan ◽  
Emrah B. Edis ◽  
Pinar Mizrak Ozfirat
Keyword(s):  
Artificial Intelligence ◽  
Operating Room ◽  
Management Problem ◽  
Operating Room Management ◽  
Scheduling Problems ◽  
Operating Room Scheduling ◽  
Surgical Units ◽  
The 1960S ◽  
Room Time ◽  
Operating Room Time

Surgical units are generally the most costly and least utilized units of hospitals. In order to provide higher utilization rates of surgical units, scheduling of operating rooms should be done effectively. Inefficient or inaccurate scheduling of operating room time often results in delays of surgery or cancellations of procedures, which are costly to the patient and the hospital. Therefore, operating room scheduling and management problems have been an important area of research both for operations researchers and artificial intelligence researchers since the 1960s. In this chapter, the operations research and artificial intelligence solutions developed for operating room scheduling problems in the operational level are examined and discussed. The studies are classified according to the approaches employed. The chapter is aimed to be helpful for researchers who are willing to make contributions in this area as well as the practitioners who are looking for efficient and effective ways to handle the operating room management problem of their own.

scholarly journals Predictors of Total Operating Room Time for Minimally Invasive Benign Hysterectomy

2020 ◽  
Vol 27 (7) ◽  
pp. S55
Author(s):  
A.S. Frost ◽  
J.R. Kohn ◽  
M.E. McMahon ◽  
A. Tambovtseva ◽  
M.F. Hunt ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Operating Room ◽  
Room Time ◽  
Operating Room Time

scholarly journals Factors Predicting Operating Room Time in Ureteroscopy and Ureterorenoscopy

2018 ◽  
Vol 12 (4) ◽  
pp. 195-200
Author(s):  
Ioannis KatafigiotisItay ◽  
Itay M. Sabler ◽  
Eliyahu M. Heifetz ◽  
Ayman Isid ◽  
Stavros Sfoungaristos ◽  
...  
Keyword(s):  
Operating Room ◽  
Renal Stones ◽  
Demographic Parameters ◽  
Surgical Team ◽  
X Ray ◽  
Multiple Parameters ◽  
Surgeon Experience ◽  
Regression Test ◽  
Room Time ◽  
Operating Room Time

Backgrounds/Aims: Operation room (OR) time is of great value affecting surgical outcome, complications and the daily surgical program with financial implications. Methods: We retrospectively evaluated 570 consecutive patients submitted to ureteroscopy or ureterorenoscopy for the treatment of ureteral or renal stones. Demographic parameters, patient's stones characteristics, type of ureteroscope, surgeon experience and surgical theater characteristics were analyzed. OR time was calculated from the initiation of anesthesia to patient extubation. Multivariate analysis was conducted using a linear regression test with multiple parameters to identify predictors of OR time. Results: Eight factors were identified as significant. These include total stones volume, ureteroscope used, stone number, nurses experience, radio-opacity of the stone on kidney-ureter-bladder X-ray, main surgeon experience, operating room type, and having a nephrostomy tube prior to surgery. Conclusions: The surgical team experience and familiarity with endourological procedure, and the surgical room characteristics has a crucial impact on OR time and effectiveness.

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