Frontiers in Surgery (Jun 2023)

Standardized digital solution with surgical procedure manager (SPM®)—an opportunity for maximizing patient safety and efficiency in ileostomy reversal?

  • Rahel M. Strobel,
  • Christian H. W. Schineis,
  • Leyre Lasierra Viguri,
  • Andrea Stroux,
  • Sophie M. Eschlböck,
  • Leonard A. Lobbes,
  • Ioannis Pozios,
  • Claudia Seifarth,
  • Benjamin Weixler,
  • Carsten Kamphues,
  • Katharina Beyer,
  • Johannes C. Lauscher

DOI
https://doi.org/10.3389/fsurg.2023.1141017
Journal volume & issue
Vol. 10

Abstract

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BackgroundStandardization and digitalization are getting more and more essential in surgery. Surgical procedure manager (SPM®) is a freestanding computer serving as a digital supporter in the operating room. SPM® navigates step-by-step through surgery by providing a checklist for each individual step.MethodsThis was a single center, retrospective study at the Department for General and Visceral Surgery at Charité—Universitätsmedizin Berlin, Campus Benjamin Franklin. Patients who underwent ileostomy reversal without SPM® in the period of January 2017 until December 2017 were compared to patients who were operated with SPM® in the period of June 2018 until July 2020. Explorative analysis and multiple logistic regression were performed.ResultsOverall, 214 patients underwent ileostomy reversal: 95 patients without SPM® vs. 119 patients with SPM®. Ileostomy reversal was performed by head of department/attendings in 34.1%, by fellows in 28.5% and by residents in 37.4%; p = 0.91. Postoperative intraabdominal abscess emerged more often in patients without SPM®: ten (10.5%) patients vs. four (3.4%) patients; p = 0.035. Multiple logistic regression showed a risk reduction for intraabdominal abscess {Odds ratio (OR) 0.19 [95% confidence interval (CI) 0.05–0.71]; p = 0.014} and for bowel perforation [OR 0.09 (95% CI 0.01–0.93); p = 0.043] in the group with use of SPM® in ileostomy reversal.ConclusionsSPM® may reduce postoperative complications in ileostomy reversal such as intraabdominal abscess and bowel perforation. SPM® may contribute to patient safety.

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