Evidence map›Paper›PMID 26310531›Full record

ArticleSurgical endoscopy2016

Microcomplications in laparoscopic cholecystectomy: impact on duration of surgery and costs.

Marco von Strauss Und Torney, Salome Dell-Kuster, Henry Hoffmann, Urs von Holzen, Daniel Oertli, Rachel Rosenthal

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Trial
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  5. Observational
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  10. Predictors of postoperative hemoglobin drop after laparoscopic myomectomy.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2017
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Marco von Strauss Und TorneyDepartment of Surgery, University Hospital Basel, Basel, Switzerland. marco.vonstrauss@ksa.ch.
Salome Dell-KusterDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Henry HoffmannDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Urs von HolzenDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Daniel OertliDepartment of Surgery, University Hospital Basel, Basel, Switzerland.
Rachel RosenthalDepartment of Surgery, University Hospital Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the era of cost-constrained health care, optimal resource utilisation becomes fundamental in daily clinical practice. Currently, processes during surgery are poorly defined and workflows need to be scrutinised. This investigation aimed at identifying interruptions of surgical workflow and quantifying their impact on the duration of surgery and costs.

methodsInterruptions of surgical workflow were defined as microcomplications (MC) and divided into the following subgroups: communication-related (CR), instrument changes (IC), missing instruments (MI), instrument failure (IF), waiting for a senior surgeon (SS), anaesthesia-related (AR) and position changes (PC). Audio-video records of laparoscopic cholecystectomies were reviewed regarding type, frequency and duration of MC. Risk factors for MC were investigated in a multivariable linear regression analysis. The costs of MC due to intraoperative delay were calculated.

resultsTwenty audio-video records of laparoscopic cholecystectomies with a total duration of 28.9 h were reviewed. The median frequency of MC was 95 events/h with an overall duration of 452 min, corresponding to a delay of 15.6 min/h. Most frequent causes for MC were CR (32 events/h) and IC (54 events/h), leading to a total delay of 6.5 min/h for CR and 4.5 min/h for IC, respectively. MI and IF were less frequent (2.0 and 5.4 events/h), but single events lasted longer, resulting in a total delay of 1.4 min/h in MI and 2.1 min/h in IF. Intraoperative delays due to SS, AR or PC were rare. Multivariable regression analysis revealed previous abdominal surgery and cholecystitis as risk factors for a longer duration of MC (p = 0.004; p = 0.046). Based on OR minute costs of € 31.98, the delay due to MC led to additional costs of € 499/h.

conclusionsMC cause relevant intraoperative delay and increased costs. Step-by-step protocols for a laparoscopic cholecystectomy may lead to a reduction in MC and should be further evaluated.

Indexed as

Cholecystectomy, LaparoscopicWorkflowAdultCommunicationFemaleHumansIntraoperative ComplicationsMaleMiddle AgedOperating RoomsSurgical InstrumentsCostsDisruptionDuration of surgeryIntraoperative delayLaparoscopic cholecystectomyWorkflow

Identifiers

PMID26310531

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.