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Technology
Streamlining minimally invasive surgeries
Artificial intelligence (AI) and robotics are
playing an important role in the surgical
suite, providing clinical insights and guiding
surgical tools during procedures such as
minimally invasive lumbar fusion surgeries.
These tools provide accuracy and precision
over manual surgeries, including 3D
imaging and the ability to place screws with
microlevel precision.
The startup Kaliber has developed an
AI-powered surgical toolkit that includes
preoperative communication tools; surgical
assistance, feedback, and analytics in the
OR; a personalized postoperative report
with AI-labeled surgical imaging and videos
to which patients can refer when communicating
with their surgical team and physical
therapist; and shareable intraoperative
imaging and videos that physical therapists
can use as they develop and adjust their
patients' rehabilitation protocols.
The Mazor X robotic surgical system provides
surgeons with 3D software to preplan
spinal procedures, and it guides the
surgeon's tools following a blueprint that
allows them to safely and accurately place
implants. The software's sophisticated visualization
capacity means less risk of exposure
to radiation, fewer complications,
less pain, and reduced need for repeat
surgeries.
dures earlier in the week, can cause excess
burden on postoperative services
and staff, which in turn accelerates
burnout and lowers job satisfaction.
In one study of The Ottawa Hospital,
Canada, conducted between 2012
and 2014, researchers looked at over
15,000 noncardiac emergency surgery
patients and found that delays ranged
from 45 minutes to up to 24 hours.
Some 2,820 patients experienced a
delay, and mortality increased from
3.2% for patients without delays to
4.9% for patients with delays. Delays
had led to thousands in cost increases
as well.
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OR Manager | Nov/Dec 2023
Intuitive's da Vinci platforms have been
part of minimally invasive surgeries in the
OR for over 21 years. The system involves a
surgeon's console which guides the robotic
parts and a cart with three to four robotic
arms that can operate as surgical instruments
such as scalpels and graspers. There
are also 3D cameras. Da Vinci's software
gives on-screen notifications to guide surgeons
through procedures as well as analytics
and training opportunities.
Asensus Surgical uses data to drive a
laparoscopic AI robot that relays information
like tissue size to surgeons. Now the
company has taken feedback received from
over 10,000 digital laparoscopic procedures
to create its next generation digital
surgery platform, the LUNA Surgical System.
The system involves advanced minimally
invasive instrumentation, a digital
interface between the surgeon and the console,
and clinical intelligence tools.
References
Lovell K. Are robots for spine surgery worth
the cost? SpineUniverse. January 19,
2021.
Spine surgery robots Market: Global industry
analysis by size, share, growth,
trends, and forecast, 2023-2031. Transparency
Market Research. July 2023.
OR suites need to maximize efficiency
by maintaining separate patient
flows for elective and emergency procedures,
notes an Institute for Healthcare
Improvement whitepaper: " Delays in
instituting care for urgent or emergent
OR cases may lead to increased risk of
progressive disease, complications, and
poor outcomes. " They advise hospitals
to increase OR workflow efficiencies,
first by identifying key processes, then
by implementing best practices.
Making data useful
" Everyone has a perceived notion of
what they think the problem is, " says
Stephen Kucinski, an
OR informatics specialist
at Thomas Jefferson
University Hospitals.
" Once you analyze data,
you see a cumulation of
issues along the way. "
Kucinski began as a
supervisor in the DepartStephen
Kucinski
ment
of Nursing, on the ground floor
managing prepping rooms and turnover,
before moving into data collection and
informatics. Now, he is leading a pilot
initiative in the Thomas Jefferson health
system, which includes 18 hospitals in
total, to understand where inefficiencies
lie and use data to help drive improvements.
One of the first issues they addressed
was late start times.
Monica Young, DNP,
MSN, MHA, VP of perioperative
services at
Thomas Jefferson University
Hospitals, says
they switched from having
nurses manually
enter delay codes-of
which there were 80 options
which were often
not being entered or entered correctly-
to using time stamps. Surgeons were
given 15 minutes before being considered
responsible for a delay; anesthesiologists
had 10 minutes, and nurses
had 5 minutes.
Monica
Young, DNP,
MSN, MHA
" We saw the biggest jump in first
case on-time starts when we switched
to time stamps, " Young says. She adds
that, ultimately, they found that there
was not one group that was more responsible
for delays, but rather a fairly
even split between the three.
The team provides morning reports
around 9:30 am each day to let managers
know where they fell short and
which areas are responsible-preoperative,
postoperative, registration, etc-
aiming for 75% of procedures to be
on time. Each month, they look at the
numbers, and the most reported issues
to see where they can improve.
www.ormanager.com
https://pro.spineuniverse.com/news/robots-spine-surgery-worth-cost https://www.transparencymarketresearch.com/spine-surgery-robots-market.html http://www.ormanager.com
orm_november-2023

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