Cost of OR Time is $46.04 per Minute

Smith, Tyler; Evans, Justin J.; Moriel, Karla; Tihista, Mikel; Bacak, Christopher; Dunn, John C.; Rajani, Rajiv; Childs, Benjamin R.

doi:10.55576/job.v2i4.23

Cited by 17 publications

(13 citation statements)

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“…Increased operative time may be due to general factors such as positioning, induction, and intubation, or technical challenges during surgery, such as more tissue to dissect and suture. This has significant financial implications, as average operating costs have increased from $20/min in 1991 to $46/min in 2022 30–32 . While operative times may increase with a higher BMI given that there may be more tissue to dissect and reconstruct, physician experience in oncoplastic surgery also plays an independent role in OR time efficiency, with an increased experience level leading to less operative time 14 .…”

Section: Discussionmentioning

confidence: 99%

The impact of body mass index on oncoplastic breast surgery: A multicenter analysis

De La Cruz Ku,

Camarlinghi,

Mallouh

et al. 2023

Journal of Surgical Oncology

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BackgroundObesity has nearly tripled in the last 50 years. During the last decades, oncoplastic breast surgery has become an important choice in the surgical treatment of breast cancer. An association exists between higher body mass index (BMI) and wound complications for major operations, but there is scarce literature on oncoplastic surgery. Hence, our aim was to compare the complication rates among patients who underwent oncoplastic surgery, stratified by BMI.MethodsPatient data were analyzed from the National Surgical Quality Improvement Program database (NSQIP) for oncoplastic breast procedures (2005–2020). Patients were stratified according to World Health Organization obesity classifications. Multivariate logistic regression was performed to assess risk factors for complications (overall, operative, and wound‐related).ResultsFrom a total of 6887 patients who underwent oncoplastic surgery, 4229 patients were nonobese, 1380 had Class 1 obesity (BMI: 30 to <35 kg/m2), 737 Class 2 obesity (BMI: 35 to <40 kg/m2), and 541 Class 3 obesity (BMI: ≥ 40 kg/m2). Greater operative time was found according to higher BMI (p < 0.001). Multivariate analysis adjusted for baseline characteristics showed that patients with obesity Class 2 (odds ratio [OR] = 1.51, 95% confidence interval [CI]: 1.03–2.23, p = 0.037) and 3 (OR = 1.87, 95% CI 1.24–2.83, p = 0.003) had increased risk of overall and wound complications compared with Nonobese patients. Comparing obese with nonobese patients, there were no differences in rates of deep SSI, organ/space SSI, pneumonia, reintubation, pulmonary embolism, deep vein thrombosis, urinary tract infection, stroke, bleeding, postoperative sepsis, length of stay, and readmission.ConclusionsOncoplastic surgery is a safe procedure for most patients. However, caution should be exercised when performing oncoplastic surgery for patients with Class 2 or 3 obesity (BMI ≥ 35 kg/m2), given there was a higher rate of overall and wound‐specific complications, compared with patients who were not obese or had Class 1 obesity.

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Section: Discussionmentioning

confidence: 99%

The impact of body mass index on oncoplastic breast surgery: A multicenter analysis

De La Cruz Ku,

Camarlinghi,

Mallouh

et al. 2023

Journal of Surgical Oncology

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“…An article by reported additional time of 21-30 min for manually searching the needle and additional 31-40 min for x-ray totaling 70 min of added OR time. The OR cost per minute has been previously reported to be $16-$115 (Smith et al, 2022). However, when considering studies after 2020, the cost is $62-$115 (Smith et al, 2022).…”

Section: Cost Burden Of the Current Retrieval Protocolmentioning

confidence: 99%

“…The OR cost per minute has been previously reported to be $16-$115 (Smith et al, 2022). However, when considering studies after 2020, the cost is $62-$115 (Smith et al, 2022). Thus, the additional time translates into a cost of $4340-$8050.…”

Section: Cost Burden Of the Current Retrieval Protocolmentioning

confidence: 99%

Assessment of x‐ray efficacy for intraoperative microneedle retrieval using a cadaveric model

Chaker,

Hung,

Vinson

et al. 2024

Microsurgery

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IntroductionInstitutional protocols often mandate the use of x‐rays when a microneedle is lost intraoperatively. Although x‐rays can reliably show a macroneedle, the benefit of x‐rays in detecting microneedles in human tissues has not been established as available data on this topic are investigated in anthropometric models. The current study aims to evaluate whether x‐rays can reliably detect retained microneedles in a human cadaveric model. We hypothesize that microneedles would be detected at a significantly lower rate than macroneedles by x‐ray in human tissues.Materials and MethodsNeedles ranging from 4‐0 to 10‐0 were placed randomly throughout a cadaveric hand and foot. Each tissue sample was x‐rayed using a Fexitron X‐Ray machine, taking both anteroposterior and lateral views. A total of six x‐ray images were then evaluated by 11 radiologists, independently. The radiologists circled over the area where they visualized a needle. The accuracy of detecting macroneedles (size 4‐0 to 7‐0) was compared with that of microneedles (size 8‐0 to 10‐0) using a chi‐square test.ResultsThe overall detection rate for the microneedles was significantly lower than the detection rate for macroneedles (13.5% vs 88.8%, p < .01). When subcategorized between the hand and the foot, the detection rate for microneedles was also significantly lower than the rate for macroneedles (hand: 7.6% for microneedles, 93.2% for macroneedles, p < .01; foot: 19.5% for microneedles, 84.4% for macroneedles, p < .01). The detection rate, in general, significantly decreased as the sizes of needles became smaller (7‐0:70.5%, 8‐0:18.2%, 9‐0:16.7%, 10‐0:2.3%, p < .01).ConclusionX‐rays, while useful in detecting macroneedles, had a significantly lower rate of detecting microneedles in a cadaveric model. The routine use of x‐rays for a lost microneedle may not be beneficial. Further investigation with fresh tissue and similar intraoperative x‐ray systems is warranted to corroborate and support these findings.

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“…Results of a 2022 literature review showed that the mean OR time cost per minute was $46.04 (SD = $32.31). 5 Using an estimate of $46 per minute, a 15-minute delay at the beginning of the day in one OR for 250 weekdays would cost a facility $172,500 annually. Although perioperative leaders and nurses may associate procedure delays with weekday surgery schedules, in some instances, facility leaders may plan scheduled procedures on weekends.…”

Section: Significance Of the Problemmentioning

confidence: 99%

“…Delays at the beginning of the day may adversely affect patients, surgeons, anesthesia professionals, perioperative personnel, and inpatient nurses. Results of a 2022 literature review showed that the mean OR time cost per minute was $46.04 (SD = $32.31) 5 . Using an estimate of $46 per minute, a 15‐minute delay at the beginning of the day in one OR for 250 weekdays would cost a facility $172,500 annually.…”

Section: Significance Of the Problemmentioning

confidence: 99%