Effects of Operating Room Equipments and Staff in Laparoscopic Cholecystectomy

Year 2012, Volume: 13 Issue: 3, 19 - 23, 01.12.2012

Nurettin Kahramansoy Mehmet Reşit Sönmez Feyzi Kurt Hayri Erkol Cavit Çöl

Abstract

OBJECTIVE: Among many factors affecting the duration of operation, conversion to open, and complication frequency in laparoscopic cholecystectomy, characteristics of patient and experience of the surgeon can be suggested initially. Moreover such factors as operating room equipments, and team features could be effective. The aim of this study is to define the effects of these factors in laparoscopic cholecystectomy. MATERIALS and METHODS: Laparoscopic cholecystectomies were performed by the same experienced surgeons in different health centers. These centers were different from each other in the characteristics of the operating rooms and the team features. The first center was more disadvantaged than the second. Therefore two groups were defined. The frequency of conversion to open and complication, and duration of the operation were compared. RESULTS: There were 427 patients analyzed. Mean age was about 46 years in two periods. The frequencies of female gender, laparoscopic cholecystectomy, and acute cholecystitis were significantly high in the second period. Among the patients in whom laparoscopic cholecystectomy were performed, the frequency of acute cholecystitis increased from 3% to 27% in the second period. However, the frequency of conversion to open decreased from 10.8% to 2.1% and the duration of the operation (median from 102 minutes to 50 minutes) shortened in the second period. Complication frequency did not show difference among the groups (1%). CONCLUSION: Apart from the factors related to the patient and independent from the surgeon's experience, factors as better operating room equipments and team features decrease the frequency of conversion to open and shorten the duration of operation in laparoscopic cholecystectomy.

Keywords

Laparoscopic cholecystectomy, gallbladder, operating room, conversion

References

• Ibrahim S, Tay KH, Lim SH, Ravintharan T, Tan NC. Analysis of a structured training programme in laparoscopic cholecystectomy. Langenbecks Arch Surg 2008;393:943-8.
• Vanek VW, Rhodes R, Dallis DJ. Results of laparoscopic versus open cholecystectomy in a community hospital. South Med J 1995;88:555-66.
• Kologlu M, Tutuncu T, Yuksek YN, Gozalan U, Daglar G, Kama NA. Using a risk score for conversion from laparoscopic to open cholecystectomy in resident training. Surgery 2004;135:282-7.
• Dexter F, Davis M, Egger Halbeis CB, Marjamaa R, Marty J, McIntosh C, Nakata Y, Thenuwara KN, Sawa T, Vigoda M. Mean operating room times differ by 50% among hospitals in different countries for laparoscopic cholecystectomy and lung lobectomy. J Anesth 2006;20:319-22.
• Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, Roby SR, Front ME, Carey LC. Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients. Ann Surg 1991;213:3-12.
• Bender JS, Duncan MD, Freeswick PD, Harmon JW, Magnuson TH. Increased laparoscopic experience does not lead to improved results with acute cholecystitis. Am J Surg 2002;184:591-4.
• Akoðlu M, Ercan M, Bostanci EB, Teke Z, Parlak E. 7.
• Surgical outcomes of laparoscopic cholecystectomy in scleroatrophic gallbladders. Turk J Gastroenterol 2011; 22:183-9.
• Vi s s e r B C , P a r k s RW, G a r d e n O J . O p e n cholecystectomy in the laparoendoscopic era. Am J Surg 2008; 195:108-14.
• Wolf AS, Nijsse BA, Sokal SM, Chang Y, Berger DL. Surgical outcomes of open cholecystectomy in the laparoscopic era. Am J Surg 2009;197:781-4.
• Endosc 2008;22:2238-43.
• Buzink SN, van Lier L, de Hingh IH, Jakimowicz JJ. R i s k - s e n s i t i v e e v e n t s d u r i n g l a p a r o s c o p i c 8.
• cholecystectomy: the influence of the integrated operating room and a preoperative checklist tool. Surg Endosc 2010; 4:1990-5. 9.
• Kundhal PS, Grantcharov TP. Psychomotor performance measured in a virtual environment correlates with technical skills in the operating room. Surg Endosc 2009;23:645-9.
• Alponat A, Kum CK, Koh BC, Rajnakova A, Goh PM. Predictive factors for conversion of laparoscopic cholecystectomy. World J Surg 1997;21:629-33.
• Genc V, Sulaimanov M, Cipe G, Basceken SI, Erverdi 28. Stepaniak PS, Vrijland WW, de Quelerij M, de Vries G, Heij C. Working with a fixed operating room team on consecutive similar cases and the effect on case duration and turnover time. Arch Surg 2010;145:1165- 70.
• necessitates the conversion to open cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations. Clinics (Sao Paulo) 2011;66:417-20.
• Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg 2008;247:699-706.
• Ercan M, Bostanci EB, Teke Z, Karaman K, Dalgic T, 30. Berguer R, Forkey DL, Smith WD. Ergonomic Ulas M, Ozer I, Ozogul YB, Atalay F, Akoglu M. Predictive factors for conversion to open surgery in p a t i e n t s u n d e rg o i n g e l e c t i v e l a p a r o s c o p i c cholecystectomy. J Laparoendosc Adv Surg Tech A 2010;20:427-34.
• problems associated with laparoscopic surgery. Surg Endosc 1999;13:466-8. YAZIÞMA ADRESÝ
• Tekin A. Laparoskopik kolesistektomi: bir cerrahýn Yrd. Doç. Dr. Nurettin KAHRAMANSOY
• Abant Ýzzet Baysal Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, BOLU, TÜRKÝYE
• Gelmini R, Franzoni C, Zona S, Andreotti A, Saviano M. Laparoscopic cholecystectomy with Harmonic scalpel. JSLS 2010;14:14-9. E Posta
• : [e-mail]
• Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR. Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. J Gastrointest Surg 2002;6:800-5. Geliþ Tarihi
• Kabul Tarihi : 09.11.2012
• Teoh AY, Chong CN, Wong J, Lee KF, Chiu PW, Ng SS, Lai PB. Routine early laparoscopic cholecystectomy for acute cholecystitis after conclusion of a randomized controlled trial. Br J Surg 2007;94:1128-32.
• Zaydfudim V, Russell RT, Feurer ID, Wright JK, Pinson CW. Drain use after open cholecystectomy: is there a justification? Langenbecks Arch Surg 2009;394:1011- 7.
• Aktan AÖ, Büyükgebiz O, Yeðen C, Güllüoðlu BM, Yalýn R. Laparoskopik kolesistektomi gerçekten "minimal invaziv" mi? Ulusal Cerrahi Dergisi 1994;10:104-9.
• Ersoy E, Bozkurt Þ, Tekin E, Taneri F, Oðuz M. Laparoskopik kolesistektomide dren kullanýmý. End- Lap ve Minimal Ýnvaziv Cerrahi Derg 1998;5:35-7.
• Hatipoðlu S, Kahramansoy N, Moran M, Polat A, Külah B, Oruç T, Kulaçoðlu H, Özer MV, Coþkun F. The use of drains in laparoscopic cholecystectomy. 'Nineth International Congress of the European Association for Endoscopic Surgery' Kongre Kitabý, 13-16 June 2001.
• Csikesz NG, Singla A, Murphy MM, Tseng JF, Shah SA. Surgeon volume metrics in laparoscopic cholecystectomy. Dig Dis Sci 2010;55:2398-405.
• Ammori BJ, Larvin M, McMahon MJ. Elective laparoscopic cholecystectomy: preoperative prediction of duration of surgery. Surg Endosc 2001;15:297-300.
• Paolucci V, Schaeff B, Gutt CN, Encke A. Disposable versus reusable instruments in laparoscopic cholecystectomy. A prospective, randomised study. Endosc Surg Allied Technol 1995;3:147-50.
• Geryane MH, Hanna GB, Cuschieri A. Time-motion analysis of operation theater time use during laparoscopic cholecystectomy by surgical specialist residents. Surg Endosc 2004;18:1597-600.
• Verdaasdonk EG, Stassen LP, Hoffmann WF, van der Elst M, Dankelman J. Can a structured checklist prevent problems with laparoscopic equipment? Surg