Optimizing OR Utilization with Low-Complexity Surgeries During COVID-19
Overview
This study evaluated 524 Port-a-cath procedures performed either in an outpatient surgical centre (OSC) or central operating room (COR) during the COVID-19 pandemic. Results demonstrated that OSC procedures had significantly shorter incision-to-suture and preparation-to-incision times, with comparable complication rates and high patient satisfaction, suggesting improved OR efficiency.
Background
The COVID-19 pandemic drastically reduced elective surgeries worldwide to preserve hospital and intensive care capacity. While emergency and cancer surgeries continued, low-complexity procedures like Port-a-cath implantations faced limited OR availability. These ports are critical for timely chemotherapy initiation in cancer patients. Performing such procedures in outpatient surgical centres may optimize OR utilization by freeing central OR capacity for urgent cases.
Data Highlights
Parameter
OSC (Outpatient Surgical Centre)
COR (Central Operating Room)
p-value
Incision-to-suture time (implantation)
Not specified
Not specified
NS
Incision-to-suture time (explantation)
36 min
42 min
0.032
Total OR time
1:08 h
1:20 h
NS
Preparation-to-incision time
12 min
17 min
0.002
Postoperative complications (grade II & III, implantation)
5.2%
7.3%
NS
Perioperative complications (arterial puncture)
2.2%
2.1%
NS
Long-term complications (infection, thrombosis)
3.1%
5.2%
NS
Key Findings
524 patients underwent Port-a-cath procedures; 277 in OSC and 244 in COR.
Incision-to-suture time for explantation was significantly shorter in OSC (36 vs. 42 minutes, p=0.032).
Preparation-to-incision time was significantly reduced in OSC (12 vs. 17 minutes, p=0.002), contributing to overall faster OR turnover.
Postoperative complication rates (grade II and III) were low and similar between OSC (5.2%) and COR (7.3%).
No grade IV or V complications occurred in either group.
Patient satisfaction in OSC was high, with over 75% recommending the centre and most rating scheduling and management as very good or good.
Clinical Implications
Performing low-complexity procedures such as Port-a-cath implantations in outpatient surgical centres can optimize operating room utilization during pandemic-related capacity constraints. This approach maintains patient safety and satisfaction while reducing procedure and preparation times, thereby freeing central OR resources for urgent and complex surgeries.
Conclusion
Low-complexity surgical procedures conducted in outpatient surgical centres during the COVID-19 pandemic demonstrated improved efficiency without compromising safety or patient satisfaction. This model supports strategic OR resource allocation in times of healthcare system strain.
References
Klinikum rechts der Isar, Technical University Munich Study 2019-2020 -- Optimizing Operating Room Utilization Through Low-Complexity Surgical Procedures During the COVID-19 Pandemic
by Thomas Vogel, Dina Schippers, Balqees Aldarweesh, Ilaria Pergolini, Martina Stollreiter, Klaus Wagner, Dirk Wilhelm, Helmut Friess, Michael Kranzfelder
Patients with preoperative vitamin D deficiency had higher postoperative pain scores and opioid use after mastectomy, including more than triple the odds of moderate to severe pain within 24 hours of surgery.
