1231 Using Novel Technologies and Innovative Theatre Utilisation Procedures to More Than Triple Operating Theatre Output

Abstract

Abstract Aim In the current climate of extended waiting lists and increasing demands on theatre time and personnel, efficiency gains are vital in shaping the future of surgical practice. We have utilised novel surgical technology to drive massive increases in throughput for one of the most commonly performed procedures worldwide (tonsillectomies). Method Use of the BiZactTM device, a vessel sealing bipolar instrument, has been shown in our trust and worldwide to be safe and offer greater efficiency. We combined this with a conveyor-belt style theatre arrangement - with a second team preparing and anaesthetising the following patient simultaneously, and changes to anaesthetic and post-op procedures to maximise productivity. Results Contrasting the GIRFT recommended 3 adult half day tonsillectomy list, we were able to safely perform 10 adult tonsillectomies in one session, with no change in expected post-operative complication rates. Average time recorded on the theatre system was 10m:00s per patient, with the average time-on-tonsil just 2m:59s. There was 1 patient who presented post-operatively with secondary haemorrhage that was managed conservatively. Conclusions The implementation of efficient technology, combined with innovative theatre procedural technique, short lasting anaesthetics and reduced post operative observation time allowed the half day list capacity to be increased by 333%. Complication rates in this case, and in our wider use of this technique (n=103), have been within normal range, whilst allowing greatly increased efficiency and rapid reduction of local waiting lists. Lessons learned from this conveyor-belt style practice have wide ranging potential applications across specialties that will drive efficient future practice.