Presented by: Eyal Riemer MD
Hadassah Hospital Jerusalem, Dept. of Urology.

Introduction

Ureteroscopy for the treatment of urolithiasis is one of the most common procedures in the world of endourology. This study seeks to compare several operating room time measurements between a general anesthetist and a specialized endourology anesthetist in holmium laser lithotripsy ureteroscopy procedures.

Materials

A retrospective observational study was performed over a database of 2380 ureteroscopy procedures collected since October 2013 by the endourology unit of a single tertiary center. The data was divided into two categories according to the performing anesthetist: procedures performed with a specialized endourology Anesthetist (SA) and procedures performed with a general non-specialized Anesthetist (GA). The two outcomes analyzed were Total Operation Time (TOT), which was measured from patient intubation to patient extubation, and Surgical Time (ST), which was measured from the beginning of the surgeon’s performance to it’s end. A secondary outcome measured was the proportion of ST from TOT (PST).     Statistical analysis was performed using IBM SPSS version 29.

Results

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2260 procedures were analyzed, 1887 in the SA group and 373 in the GA group. Significant difference was found across all outcomes analyzed. Mean ST was  30.07±17.49 minutes for the SA group, vs. 32.40±19.90 minutes in the GA group p_val=0.018). Mean TOT was 49.89±22.97 minutes for the SA group, vs. 61.85±31.57 minutes in the GA group (p_val<0.001).  Mean PST was 60.17 ± 19.05 in the SA group vs. 54.54 ± 20.48 minutes in the GA group (p_val<0.001).

Conclusion

A constant specialized endourology anesthetist as part of the endourology O.R team had a statistically significant advantage in both TOT and ST, and also in the proportion of time in the O.R spent performing surgery. Our findings suggest that not only is anesthesia time shorter in such a team, but it also allows the surgeons to be more time efficient.

Funding

None

Lead Authors

Amitay Lorber, MD
Hadassah Hospital Jerusalem, Dept. of Urology, Endourology Unit.

Co-Authors

Leonid Boyarsky, MD
Hadassah Hospital Jerusalem, Dept. of Urology.

Ofer Gofrit, MD
Hadassah Hospital Jerusalem, Dept. of Urology.

Mordechai Duvdevani, MD
Hadassah Hospital Jerusalem, Dept. of Urology, Endourology Unit.