OR Manager August 2023 - 30

Patient Safety
als-about a 22% success rate. But in
the device group, with 51 participants,
the success rate was significantly
higher at 98.1%.
And when they did find the needle
in those successful trials, the device
group was much faster than the control
group. On average,
it took the device
group only 1.64 minutes to find the
needle, while the control group took
3.34 minutes. That's a substantial and
statistically significant difference.
In the second scenario, the control
group, consisting of 34 participants, accurately
identified the presence of the
needle 58.8% of the time, and the device
group, also with 34 participants,
achieved a perfect accuracy of 100%.
The device group also took significantly
less time to determine the presence
of the needle compared to the control
group, at 1.69 minutes compared to
4.89 minutes (sidebar, 'Needle in a haystack'
experiment).
Q: For an OR manager, there are two
main questions guiding the decision
to use adjacent technology: how accurate
is it when determining the
presence of a needle, and how long it
takes to make that determination? Did
this study illustrate answers to these
questions?
The groups using the MSF demonstrated
improved accuracy in identifying
the presence of a needle, and they
achieved a higher rate of successful
Adjacent
technology helps
address miscounts.
This study's first step was an ex-vivo
experiment-like I said, the participants
tried to find a needle in a container
filled with hay using either a grasper
or the MSF. When using the MSF, they
could not move the hay or the container
with their free hands.
The study's second and third steps
involved in-vivo scenarios. For these
experiments, which were approved by
the animal care committees at Virginia
Commonwealth University and the University
of California Irvine, we used live
male Yorkshire pigs as our model. We
anesthetized them and accessed their
abdomen using both laparoscopic [second
step] and laparotomy [thid step] approaches,
hid suture needles in different
parts of the abdomen, and recorded
the time it took the participants-who
were residents in general surgery and
'Needle in a haystack' experiment
identification while locating it faster.
More research will provide a more comprehensive
understanding of the device's
effectiveness and applicability
in real-world surgical settings, but the
study findings definitely indicated promising
results.
urology and not specifically trained to
search for the needle-to find them.
In the laparoscopic clinical experiments,
the participants were randomly
assigned to three groups. Some used
laparoscopic instruments with a C-arm
device, some used the MSF device plus
the C-arm machine to find the needle,
and others only used the MSF. Each
trial lasted up to 5 minutes, and we
checked the accuracy and time it took
for the participants to determine if the
needle was present.
We conducted a total of 52 trials
for the third experiment. There were
nine trials using only C-arm X-ray and
manual search; 10 trials with both
C-arm X-ray and the MSF; and 33 using
only the MSF. The distribution of needle
size, needle location, and the presence
of the needle were similar across all
groups. The accuracy and speed of determining
the presence of the needle
were similar among all three groups
(sidebar, C-arm vs C-arm and the MSF vs
the MSF experiments).
Q: Did the use of C-arm X-ray impact
these results?
Potentially, yes. This scenario used an
expensive, top-of-the-line C-arm X-ray
machine, which some hospitals may
not have readily available. It made the
whole X-ray process much more efficient,
eliminating the need to have to
use a film. And a trained radiologist
was on-hand to interpret images immediately,
which is rare. But the MSF
alone managed to locate needles at
similar success rates as the trials that
used the C-arms. So, in a real-life situation,
the MSF would likely be able to
fully determine the presence or absence
of a needle much more efficiently and
in less time than with traditional X-ray
protocols.
KEY TAKEAWAY: The group using MSF had a significantly higher success rate and took much less time to determine
the needle's presence than the control group.
Q: What about the study's third step?
In the third step, we performed laparotomy
on the pigs. The participants were
split into two groups: one doing a man30
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OR Manager August 2023

Table of Contents for the Digital Edition of OR Manager August 2023