Skip to main content
Top
Published in: International Urogynecology Journal 10/2016

01-10-2016 | Original Article

The effect of surgical start time in patients undergoing minimally invasive sacrocolpopexy

Authors: Karl Jallad, Matthew D. Barber, Beri Ridgeway, Marie Fidela R. Paraiso, Cecile A. Unger

Published in: International Urogynecology Journal | Issue 10/2016

Login to get access

Abstract

Introduction and hypothesis

The objective was to determine if the surgical start time affects operating room time and the incidence of perioperative adverse events in patients undergoing minimally invasive sacrocolpopexy.

Methods

This is a retrospective cohort of 396 women who underwent laparoscopic and robotic sacrocolpopexy at a tertiary care center between January 2006 and December 2012. Cases were divided into those with a first, second or third start time. Operating room (OR) time was defined as time the patient entered the room to time out of the room (minutes) and the case time was defined as the period between incision and closure (minutes). Adverse events were defined a priori and also reported using the Clavien–Dindo grading scale. Logistic regression analysis was performed for categorical variables and multiple linear regression analysis for continuous variables.

Results

A total of 145 robotic and 261 conventional laparoscopic minimally invasive sacrocolpopexies were performed. Operating room time data were available for 396 cases. Of the cases, 63.9 % (253 out of 396) had a first start, 32.1 % (127 out of 396) had a second start, and 4 % (16 out of 396) had a third start. Robotic and concomitant rectopexy cases were more likely to be performed as first-start cases and operating room time and case time were longest for first-start cases. However, after adjusting for mode of surgery, concomitant procedures, previous surgeries, BMI, and age, this finding was no longer statistically significant. There was no difference in the rate of perioperative adverse events among first-, and second-/third-start cases.

Conclusion

Surgical case start time does not appear to be associated with operating time or the incidence of perioperative adverse events in patients undergoing minimally invasive sacrocolpopexy.
Literature
1.
go back to reference Wright MC, Phillips-Bute B, Mark JB et al (2006) Time of day effects on the incidence of anesthetic adverse events. Qual Saf Health Care 15(4):258–263CrossRefPubMedPubMedCentral Wright MC, Phillips-Bute B, Mark JB et al (2006) Time of day effects on the incidence of anesthetic adverse events. Qual Saf Health Care 15(4):258–263CrossRefPubMedPubMedCentral
2.
go back to reference Slaughter KN, Frumovitz M, Schmeler KM et al (2014) Minimally invasive surgery for endometrial cancer: does operative start time impact surgical and oncologic outcomes? Gynecol Oncol 134(2):248–252CrossRefPubMedPubMedCentral Slaughter KN, Frumovitz M, Schmeler KM et al (2014) Minimally invasive surgery for endometrial cancer: does operative start time impact surgical and oncologic outcomes? Gynecol Oncol 134(2):248–252CrossRefPubMedPubMedCentral
3.
go back to reference Eastridge BJ, Hamilton EC, O’Keefe GE et al (2003) Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill. Am J Surg 186(2):169–174CrossRefPubMed Eastridge BJ, Hamilton EC, O’Keefe GE et al (2003) Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill. Am J Surg 186(2):169–174CrossRefPubMed
4.
go back to reference Kelz RR, Freeman KM, Hosokawa PW et al (2008) Time of day is associated with postoperative morbidity: an analysis of the national surgical quality improvement program data. Ann Surg 247(3):544–552CrossRefPubMed Kelz RR, Freeman KM, Hosokawa PW et al (2008) Time of day is associated with postoperative morbidity: an analysis of the national surgical quality improvement program data. Ann Surg 247(3):544–552CrossRefPubMed
5.
go back to reference Magid DJ, Wang Y, Herrin J et al (2005) Relationship between time of day, day of week, timeliness of reperfusion, and in-hospital mortality for patients with acute ST-segment elevation myocardial infarction. JAMA 294(7):803–812CrossRefPubMed Magid DJ, Wang Y, Herrin J et al (2005) Relationship between time of day, day of week, timeliness of reperfusion, and in-hospital mortality for patients with acute ST-segment elevation myocardial infarction. JAMA 294(7):803–812CrossRefPubMed
6.
go back to reference Sanaka MR, Deepinder F, Thota PN, Lopez R, Burke CA (2009) Adenomas are detected more often in morning than in afternoon colonoscopy. Am J Gastroenterol 104(7):1659–1664, quiz 1665CrossRefPubMed Sanaka MR, Deepinder F, Thota PN, Lopez R, Burke CA (2009) Adenomas are detected more often in morning than in afternoon colonoscopy. Am J Gastroenterol 104(7):1659–1664, quiz 1665CrossRefPubMed
7.
go back to reference Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196CrossRefPubMed Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196CrossRefPubMed
8.
go back to reference Long JS (1997) Regression models for categorical and limited dependent variables. Sage Publications, Thousand Oaks, CA Long JS (1997) Regression models for categorical and limited dependent variables. Sage Publications, Thousand Oaks, CA
9.
go back to reference Kleinbaum D, Kupper L, Nizam A, Muller K (2007) Applied regression analysis and other multivariable methods, 4th edn. Duxbury Press, Belmont, CA Kleinbaum D, Kupper L, Nizam A, Muller K (2007) Applied regression analysis and other multivariable methods, 4th edn. Duxbury Press, Belmont, CA
10.
go back to reference Paraiso MF, Jelovsek JE, Frick A, Chen CC, Barber MD (2011) Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol 118(5):1005–1013CrossRefPubMed Paraiso MF, Jelovsek JE, Frick A, Chen CC, Barber MD (2011) Laparoscopic compared with robotic sacrocolpopexy for vaginal prolapse: a randomized controlled trial. Obstet Gynecol 118(5):1005–1013CrossRefPubMed
11.
go back to reference Tan-Kim J, Menefee SA, Luber KM, Nager CW, Lukacz ES (2011) Robotic-assisted and laparoscopic sacrocolpopexy: comparing operative times, costs and outcomes. Female Pelvic Med Reconstr Surg 17(1):44–49CrossRefPubMed Tan-Kim J, Menefee SA, Luber KM, Nager CW, Lukacz ES (2011) Robotic-assisted and laparoscopic sacrocolpopexy: comparing operative times, costs and outcomes. Female Pelvic Med Reconstr Surg 17(1):44–49CrossRefPubMed
12.
go back to reference Unger CA, Paraiso MF, Jelovsek JE, Barber MD, Ridgeway B (2014) Perioperative adverse events after minimally invasive abdominal sacrocolpopexy. Am J Obstet Gynecol 211(5):547.e1–547.e8CrossRef Unger CA, Paraiso MF, Jelovsek JE, Barber MD, Ridgeway B (2014) Perioperative adverse events after minimally invasive abdominal sacrocolpopexy. Am J Obstet Gynecol 211(5):547.e1–547.e8CrossRef
Metadata
Title
The effect of surgical start time in patients undergoing minimally invasive sacrocolpopexy
Authors
Karl Jallad
Matthew D. Barber
Beri Ridgeway
Marie Fidela R. Paraiso
Cecile A. Unger
Publication date
01-10-2016
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 10/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-2994-8

Other articles of this Issue 10/2016

International Urogynecology Journal 10/2016 Go to the issue

Urogynecology Digest

Urogynecology digest