MP83-20 DOES FOOT PEDAL ILLUMINATION IMPROVE SPEED, EFFICIENCY AND ACCURACY DURING UROLOGIC SURGERY?

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety IV (MP83)1 Apr 2020MP83-20 DOES FOOT PEDAL ILLUMINATION IMPROVE SPEED, EFFICIENCY AND ACCURACY DURING UROLOGIC SURGERY? Hyelin You, Jon Maldonado*, Andrew Krause, Ashley Li, Jeremy Brown, Akin S. Amasyali, Mohammad Hajiha, Phillip Stokes, Muhannad Alsyouf, John Smith, Jason Groegler, Daniel Baldwin, and D. Duane Baldwin Hyelin YouHyelin You More articles by this author , Jon Maldonado*Jon Maldonado* More articles by this author , Andrew KrauseAndrew Krause More articles by this author , Ashley LiAshley Li More articles by this author , Jeremy BrownJeremy Brown More articles by this author , Akin S. AmasyaliAkin S. Amasyali More articles by this author , Mohammad HajihaMohammad Hajiha More articles by this author , Phillip StokesPhillip Stokes More articles by this author , Muhannad AlsyoufMuhannad Alsyouf More articles by this author , John SmithJohn Smith More articles by this author , Jason GroeglerJason Groegler More articles by this author , Daniel BaldwinDaniel Baldwin More articles by this author , and D. Duane BaldwinD. Duane Baldwin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000975.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Endourologic procedures frequently use pedal activation in a low-light operating room (OR). Foot pedal activation in low-light conditions risks incorrect pedal activation, which may increase radiation exposure, cause patient burns, or start OR fires. This study compares speed, accuracy, dark adaptation, and surgeon preference for pedal activation in 4 different lighting conditions. METHODS: During a simulated percutaneous nephrolithotomy (PCNL), pedals for fluoroscopy (c-arm), holmium laser, and ultrasonic lithotripter (USL) were randomized to 3 different positions. Twenty participants activated pedals in a randomized order in 4 settings: a dark OR with black light illumination, a dark OR with glow stick illumination, a dark OR with no foot pedal lighting, and a bright OR with overhead lights on (Fig 1). Endpoints included time to pedal activation, number of attempted, incomplete, and incorrect presses, dark adaptation, and surgeon preference. Mann-Whitney U Test was used with p<0.05 considered significant. RESULTS: Compared to no illumination (8.47 s), the glow stick (6.77s; p < 0.001) and black light fluorescent illumination (5.34s; p < 0.001) were both associated with decreased combined and individual pedal activation times (p<0.05 for c-arm, laser, and USL). The black light resulted in a significant decrease in attempted (0.30 vs 3.45, p<0.001), incomplete (1.25 vs 7.75, p<0.001), and incorrect presses (0.35 vs 1.25, p=0.035) compared to the dark setting, while demonstrating no difference compared to having room lights on. Dark adaptation was significantly improved with black light illumination compared to having the room lights on (134.5 vs 140.5 luminance units, p<0.001). Subjectively, 100% of participants preferred illuminated pedals compared to the dark OR, with 90% preferring the black light. CONCLUSIONS: During a simulated PCNL, black light foot pedal illumination significantly improved accuracy and efficiency of instrument activation compared to the conventional dark OR, while also maintaining the surgeon’s dark adaptation compared to having the overhead lights on. This study demonstrates that the use of black light foot pedal illumination may reduce errors in the operating room due to inadvertent foot pedal activation while preserving the ability to operate in a low light environment. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1263-e1263 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hyelin You More articles by this author Jon Maldonado* More articles by this author Andrew Krause More articles by this author Ashley Li More articles by this author Jeremy Brown More articles by this author Akin S. Amasyali More articles by this author Mohammad Hajiha More articles by this author Phillip Stokes More articles by this author Muhannad Alsyouf More articles by this author John Smith More articles by this author Jason Groegler More articles by this author Daniel Baldwin More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement PDF downloadLoading ...