Abstract

P 137

Computation and quantification of mean procedure courses in eye surgery on the example of cataract interventions

Thomas Neumuth1, Juliane Schlomberg2, Renate Wiedemann2, Christian Foja2, Petra Meier2, Oliver Burgert1, Peter Wiedemann2
1Innovation Center Computer Assisted Surgery, Universität Leipzig, Leipzig; 2Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Leipzig, Leipzig

Objective
Surgical Workflows were developed as a mean for the detailed analysis of procedure courses in the past few years. The application fields of Surgical Workflows cover prospective evidence-based derivation of requirements for surgical instruments and assist systems, retrospective evaluation studies, and use in surgical education and training. As innovative extension of the methodology, this work presents the computation of Surgical Workflows as statistical mean procedure courses based on individual intervention descriptions of 49 ambulatory and 53 inpatient cataract procedures. Both treatment strategies were subsequently compared to each other.
Methods
Data was obtained by trained medical observers in the Department of Ophthalmology at the University Hospital Leipzig. The observer used the Surgical Workflow Editor tool for recording, developed by the Innovation Center Computer Assisted Surgery (ICCAS). The observer was physically present in the operating room during the procedure and recorded single work steps. The records were transferred to a database system after completion of data acquisition. T-tests (α=0,05) were used to compare both strategies.
Results
Ambulatory and inpatient Surgical Workflows were compared for the example phase "Capsulorhexis" (from the beginning of the first paracentesis until end of hydrodissection). Mean performance times for work steps were different, e.g. “performing capsulorhexis with rhexis cannula" was significantly longer (t(65,09)=-8,63, p<0,001) in inpatient (64s±23s) then in ambulatory (34s±9s) procedures. Furthermore, the work step "paracentesis" was followed significantly more frequent (t(91.84)=6.80, p<0.001) by “injection of Healon” in ambulatory procedures (0,93±0,25) then in inpatient procedures (0,51±0,37).
Conclusions
Surgical Workflows are a proper mean for the identification of ideal procedure courses of surgical interventions in eye surgery. Application areas in eye surgery are the detailed comparison of intervention record populations, e.g. for quantification of advantages of surgical assist systems.

Copyright: 2009 Porstmann Kongresse GmbH. All rights reserved. Impressum, Disclaimer.