BACKGROUND AND PURPOSE:

• There has been focus on improving OR efficiencies, but there is not a lot of data on intraoperative factors such as personnel handovers
• Geynisman-Tan et al. (Female Pelvic Surgery & Reconstructive Surgery, 2018) examined whether personnel handoffs or number of learners in the OR are associated with longer OR times in women having pelvic organ prolapse surgery

METHODS:

• Retrospective review
• Participants: Women undergoing prolapse surgery
• Following factors were abstracted
  • Demographics
  • Procedure
  • OR
  • Anesthetic
  • Surgical time
  • Number of handoffs between anesthesia members
  • Circulators
  • Surgical technologies
  • Number of learners

RESULTS:

• 148 women undergoing pelvic organ prolapse surgery were included in the study
  • mean age was 54; majority white women
• Procedures performed were as follows
  • 31% laparoscopic sacrocolpopexies (LASCs)
  • 28% robotic sacrocolpopexies (RASCs)
  • 19% colpocleises
  • 22% native tissue reconstructions
• For minimally invasive sacrocolpopexies (LASC + RASC), mean OR time was 270 ± 65 minutes
• Median handovers for sacrocolpopexies
  • Anesthesia: 2 (interquartile range, 0–4)
  • Surgical technology: 1 (0–3)
  • Circulator handoffs: 2 (2–6)
• Number of learners in the OR was 4 (interquartile range, 1–7)
• Patient comorbidities and American Society of Anesthesiologists class were not associated with longer OR times
• Longer OR times were
  • Positively correlated with increasing numbers of anesthesia, surgical technology, and circulator handoffs
  • Not correlated with the number of learners
• For LASC, every technology handoff was associated with 23 additional minutes of OR time (P = 0.004)
• For RASC, every technology handoff was associated with 31 additional minutes of OR time (P = 0.007)
• Each circulator handoff was associated with 15 additional minutes (P = 0.05).

CONCLUSION:

• Increased number of anesthesia, surgical technology, and circulator handoffs were associated with longer OR times for pelvic organ prolapse surgery
• Increased number of learners did not increase time in OR

Learn More – Primary Sources:

Operating Room Efficiency: Examining the Impact of Personnel Handoffs

Related ObG Topics:

Mesh and Pelvic Organ Prolapse: ACOG Practice Advisory & ACOG/AUGS Recommendations 

Is Pelvic Muscle Strengthening Effective Following Pelvic Surgery for Prolapse and Incontinence?

Robotic vs Vaginal vs Open Surgery for Vaginal Prolapse – How Do They Compare?