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Handling moderner Bildgebung in einem Hightech-Operationssaal

Handling modern imaging procedures in a high-tech operating room

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Zusammenfassung

Operationssäle (OP) sind die zentrale Einheit im Netzwerk Krankenhaus. Hier werden hohe Kosten aber auch höchste Umsätze generiert. Moderne OP-Konzepte werden seit Anfang der 2000er Jahre auch als kommerzielle Lösungen von verschiedenen Firmen angeboten. Die Hypothese ist, dass integrative OP-Konzepte neben verbesserter Ergonomie das Potential auch zur messbaren Zeit- und Kosteneinsparung haben.

In der eigenen Klinik wurde nach Analyse der oben genannten Probleme ein solches OP-Konzept umgesetzt (I-Suite, Fa. Stryker, Duisburg). Neben einer fest installierten und deckengebundenen Anordnung beinhaltet das System eine Endoskopieeinheit und ein Navigationssystem sowie eine Sprachsteuerung des Systems. In den ersten 6 Monaten (9/2005–2/2006) wurden im OP 112 Eingriffe durchgeführt: 34 Knieprothesen, 12 endoskopische Wirbelsäuleneingriffe sowie 66 stationäre arthroskopische Eingriffe (28 Schultern, 38 Knierekonstruktionen). Dabei wurde eine tägliche Einsparung von 22–45 min (15–30% der täglichen Wechselzeit) erreicht. Entsprechend wurde ein Einsparpotential in der internen Leistungsverrechnung von täglich 225–450 EUR ermittelt.

Ein kommerzielles OP-Konzept wurde in einer Pilotphase hinsichtlich harter Daten evaluiert. Dazu gehören im Wesentlichen Zeit- und Kostenfaktoren. Neben der beschriebenen Ersparnis könnten weitere Effekte durch konsequente Nutzung der Sprachsteuerung, sowie Nutzen des sterilen Handgriffs der Navigationskamera entstehen, da das häufige Warten auf den OP-Springer entfällt. Durch die konsequente kabellose Deckenmontage ist der C-Bogen frei und ohne Kollisionsrisiko beweglich. Somit könnten die anfänglich hohen Anschaffungskosten durch eine höhere Effizienz gedämpft werden.

Abstract

Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings.

In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22–45 min, corresponding to 15–30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225–450 EUR.

A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

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  1. Unfallchirurgische Klinik, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    T. Hüfner, M. Citak, J. Imrecke, C. Krettek & T. Stübig

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  1. T. Hüfner
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  2. M. Citak
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  3. J. Imrecke
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  4. C. Krettek
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  5. T. Stübig
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Correspondence to T. Hüfner.

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Hüfner, T., Citak, M., Imrecke, J. et al. Handling moderner Bildgebung in einem Hightech-Operationssaal. Unfallchirurg 115, 220–225 (2012). https://doi.org/10.1007/s00113-012-2181-4

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