Department of Surgery, Leeuwarden Medical Center, P.O. Box 888, 8901 BR, Leeuwarden, The Netherlands.
Surg Endosc. 2009 Oct;23(10):2332-7. doi: 10.1007/s00464-009-0335-4. Epub 2009 Mar 5.
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.
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.
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).
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.
在传统手术室（OR）中进行微创手术（MIS）需要额外的专用设备，这些设备通常存放在 OR 之外。在手术前，OR 团队必须收集、准备和连接设备，然后在手术后将其带走。这些额外的任务对 OR 的效率构成了威胁，可能会延长手术交接时间。专用的 MIS 套房则永久性地安装了腹腔镜设备，可随时按需使用。本研究通过两个实验，定量分析了 MIS 套房在手术期间的效率优势。
在实验环境中和日常实践中，分析了传统 OR 和 MIS 套房中的术前准备和术后设备拆除时间。在实验环境中，随机选择的 OR 团队模拟了标准腹腔镜胆囊切除术（LC）和复杂腹腔镜乙状结肠切除术（LS）的准备和拆除工作。在临床环境中，分析了随机分配到传统 OR 或 MIS 套房的 66 例 LC 的手术期间。
在实验环境中，MIS 套房的准备和拆除时间明显更短。对于复杂手术，两种类型的 OR 之间的差异增加：LC 手术为 2:41 分钟（p < 0.001），LS 手术为 10:47 分钟（p < 0.001）。在临床环境中，MIS 套房并未整体缩短手术交接时间。腹腔镜准备和拆除时间在 MIS 套房中明显更短（平均差异 5:39 分钟；p < 0.001）。
在 MIS 套房中，手术期间的效率得到了显著提高。OR 护士的任务得到了减轻，这可能会降低心理和身体的工作负荷，提高工作满意度并提高患者安全性。由于其他学科的同时任务，无法实现整体手术交接时间的减少。
