ABSTRACT
BACKGROUND: The requirements of ENT (ear, nose and throat) surgery, i. e. operating theatre, have changed dramatically in recent years, e. g. by high definition video endoscopy, navigation, neuromonitoring, intraoperative imaging, navigated and navigation-controlled instruments and intraoperative imaging and video documentation. For this reason a specialized operating theatre is necessary for ENT. The aim of this work was to compare this operating theatre with the previous standard. MATERIAL AND METHODS: The scientific basis of this work represents a surgical workflow analysis. Over 200 completely documented operations in conventional operating theatres were available for comparison. In addition the log files of the medical technical devices, software analysis modules of the clinical documentation and ergonomics questionnaires (NASA TLX standard) were available. In the period from 1(st) June 2009 to 31(st) September 2009 a total of 139 standard procedures (9 different ENT surgeons) were analyzed in the new ly integrated operating theatre system "Surgical Deck1-ENT". RESULTS: In the newly developed operating theatre system four work areas are specified: preparation area, technical cockpit, surgical cockpit and anesthesia cockpit. The medical technical components are permanently installed. The surgical cockpit incorporates five permanently arranged monitors, two main screens, two navigation screens and a surgical dashboard. A suitable high definition video routing system is installed and procedure-specific light profiles are developed. Documentation is automatically carried out in the picture archive and communication system (PACS). The comparison to the conventional operating theatre system the slot time was reduced from 73.8 min to 65.6 min (-11%), the preoperative time was reduced on average by 31% (8 min) per case and the documentation time was decreased on average by 6 min (67%). The interaction steps of the surgeon with the system were reduced by 70% (from 17 to 5 steps). No significant differences in complications could be observed. In the total evaluation of all 16 questions on the ergonomics there was a significant improvement of the workplace layout. DISCUSSION: The presented operation unit can significantly improve safety and efficiency as well as the ergonomics for ENT surgery and related procedures.
Subject(s)
Anesthesia/methods , Models, Organizational , Operating Rooms/organization & administration , Otolaryngology/organization & administration , Otorhinolaryngologic Surgical Procedures , Surgery, Computer-Assisted/methods , Workflow , GermanyABSTRACT
Ether phospholipids have demonstrated both in vitro and in vivo activity against a wide variety of tumor cell lines. The known cyclic ether phospholipid, SRI 62-834, was used as the model to prepare eight novel phospholipids containing a cyclic ether. All of the compounds were as effective as ET-18-OCH3 in their ability to activate macrophage-induced cytotoxicity against the Abelson-8.1 tumor cell line but varied in their direct cytotoxic effects. One of the new compounds, SDZ 62-406, was selected for in vivo studies and showed oral and i.v. activity in the mouse MethA fibrosarcoma model in the same range as ET-18-OCH3. No correlation was found between the direct or macrophage-activated cytotoxicity and the ability of the compounds to inhibit or promote platelet-activating factor (PAF)-induced aggregation of human platelets.
