Operating room waste: disposable supply utilization in neurosurgical procedures.

Abstract:

:OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Zygourakis CC,Yoon S,Valencia V,Boscardin C,Moriates C,Gonzales R,Lawton MT

doi

10.3171/2016.2.JNS152442

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

620-625

issue

2

eissn

0022-3085

issn

1933-0693

journal_volume

126

pub_type

杂志文章
  • The science of cerebral ischemia and the quest for neuroprotection: navigating past failure to future success.

    abstract::Ischemic stroke remains a leading cause of morbidity and death for which few therapeutic options are available. The development of neuroprotective agents, a once promising field of investigation, has failed to translate from bench to bedside successfully. This work reviews the ischemic cascade, agents targeting steps ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/2012.11.JNS12408

    authors: Turner RC,Dodson SC,Rosen CL,Huber JD

    更新日期:2013-05-01 00:00:00

  • Magnetic resonance imaging techniques for visualization of the subthalamic nucleus.

    abstract::The authors reviewed 70 publications on MR imaging-based targeting techniques for identifying the subthalamic nucleus (STN) for deep brain stimulation in patients with Parkinson disease. Of these 70 publications, 33 presented quantitatively validated results. There is still no consensus on which targeting technique ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3171/2011.6.JNS101571

    authors: Brunenberg EJ,Platel B,Hofman PA,Ter Haar Romeny BM,Visser-Vandewalle V

    更新日期:2011-11-01 00:00:00

  • Computerized tomography and prognosis in early aneurysm surgery.

    abstract::A study of computerized tomography (CT) scans was performed in a consecutive series of 100 patients with ruptured saccular cerebral aneurysms who were admitted, diagnosed, and operated on within 72 hours after subarachnoid hemorrhage (SAH) and treated with calcium antagonists. The aneurysms were in the anterior portio...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1986.65.2.0217

    authors: Auer LM,Schneider GH,Auer T

    更新日期:1986-08-01 00:00:00

  • Outcomes and prognostic stratification of patients with recurrent glioblastoma treated with salvage stereotactic radiosurgery.

    abstract:OBJECTIVE:Glioblastoma (GBM) is the most malignant form of astrocytoma. The average survival is 6-10 months in patients with recurrent GBM (rGBM). In this study, the authors evaluated the role of stereotactic radiosurgery (SRS) in patients with rGBMs. METHODS:The authors performed a retrospective review of their brain...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.4.JNS172909

    authors: Sharma M,Schroeder JL,Elson P,Meola A,Barnett GH,Vogelbaum MA,Suh JH,Chao ST,Mohammadi AM,Stevens GHJ,Murphy ES,Angelov L

    更新日期:2018-10-19 00:00:00

  • Giant cyst of the septum pellucidum: case report.

    abstract::Symptomatic cysts of the septum pellucidum are rare. Up to 1969, 17 published cases were considered to be symptomatic. In the case report here, a 9-week-old girl was hospitalized because of disproportionate progressive enlargement of the head, lumbar myelomeningocele, and a history of generalized seizures. A giant sep...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.55.4.0646

    authors: Garza-Mercado R

    更新日期:1981-10-01 00:00:00

  • Thrombus organization and healing in an experimental aneurysm model. Part II. The effect of various types of bioactive bioabsorbable polymeric coils.

    abstract:OBJECT:Bioabsorbable polymeric material coils are being used in the endovascular treatment of aneurysms to achieve better thrombus organization than is possible using bare platinum coils. We used immunohistochemical and molecular biological analysis techniques in experimental aneurysms implanted with three different bi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/JNS-07/07/0109

    authors: Yuki I,Lee D,Murayama Y,Chiang A,Vinters HV,Nismmura I,Wang CJ,Ishii A,Wu BM,Viñuela F

    更新日期:2007-07-01 00:00:00

  • Treatment of autochthonous rat brain tumors with fractionated radiotherapy. The effects of graded radiation doses and of combined therapy with BCNU or steroids.

    abstract::The avian sarcoma virus-induced glioma model in rats was used to evaluate radiation dose response (survival curves), giving fractionated treatments to the whole head. Groups of 14 to 20 rats received total doses of 2300, 4600, or 5750 rads over 2, 4, or 5 weeks, respectively. Median group survival times were compared ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1980.53.1.0068

    authors: Steinbok P,Mahaley MS Jr,U R,Varia MA,Lipper S,Mahaley J,Dalzell JG,Bigner DD

    更新日期:1980-07-01 00:00:00

  • Frontal sinus approach to the orbit. Technical note.

    abstract::The authors have previously advocated a supraorbital approach to tumors of the orbit. In this paper, they describe a technique in which they take advantage of a large frontal sinus as a means of entering the orbit without the necessity of intracranial exposure, as required by the more conventional supraorbital approac...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.63.5.0811

    authors: Colohan AR,Jane JA,Newman SA,Maggio WW

    更新日期:1985-11-01 00:00:00

  • Measuring the health status of children with hydrocephalus by using a new outcome measure.

    abstract:OBJECT:In the preceding article, the authors described the Hydrocephalus Outcome Questionnaire (HOQ), a simple, reliable, and valid measure of health status in children with hydrocephalus. In the present study, they present their initial experience in using the HOQ to quantify the health status in a typical cohort of c...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/ped.2004.101.2.0141

    authors: Kulkarni AV,Drake JM,Rabin D,Dirks PB,Humphreys RP,Rutka JT

    更新日期:2004-11-01 00:00:00

  • Venous ischemia caused by dural arteriovenous malformation. Case report.

    abstract::A case is presented of tentorial dural arteriovenous malformation (AVM) associated with visual hallucinations and quadrant hemianopsia. Computerized tomography (CT) and magnetic resonance imaging showed an ischemic region, mainly affecting the white matter of the right occipital lobe, that was defined as an area of in...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1994.80.3.0552

    authors: Kurata A,Miyasaka Y,Yoshida T,Kunii M,Yada K,Kan S

    更新日期:1994-03-01 00:00:00

  • Comparative anatomical analysis of the transcallosal-transchoroidal and transcallosal-transforniceal-transchoroidal approaches to the third ventricle.

    abstract::OBJECTIVE Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.8.JNS16403

    authors: Vitorino Araujo JL,Veiga JCE,Wen HT,de Andrade AF,Teixeira MJ,Otoch JP,Rhoton AL Jr,Preul MC,Spetzler RF,Figueiredo EG

    更新日期:2017-07-01 00:00:00

  • Endoscopic endonasal medial-to-lateral and transorbital lateral-to-medial optic nerve decompression: an anatomical study with surgical implications.

    abstract::OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2016.8.JNS16566

    authors: Di Somma A,Cavallo LM,de Notaris M,Solari D,Topczewski TE,Bernal-Sprekelsen M,Enseñat J,Prats-Galino A,Cappabianca P

    更新日期:2017-07-01 00:00:00

  • The prophylactic use of transluminal balloon angioplasty in patients with Fisher Grade 3 subarachnoid hemorrhage: a pilot study.

    abstract:OBJECT:Recent advances in neuroradiology have made it possible to dilate vasospastic human cerebral arteries after aneurysmal subarachnoid hemorrhage (SAH), but the time window is short and the success rate for reversal of delayed ischemic neurological deficits (DINDs) varies between 31% and 77%. In a dog model of vaso...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1999.91.1.0051

    authors: Muizelaar JP,Zwienenberg M,Rudisill NA,Hecht ST

    更新日期:1999-07-01 00:00:00

  • A brachial plexopathy due to myositis ossificans. Case report and review of the literature.

    abstract::Myositis ossificans (MO) is a disorder characterized by the intramuscular proliferation of fibroblasts and osteoblasts, with subsequent deposition of bone and cartilage. A typical clinical presentation involves traumatic injury to a young adult, usually localized to the thigh, buttock, or upper arm, with resultant MO ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2001.95.3.0525

    authors: Reavey-Cantwell JF,Garonzik I,Viglione MP,McCarthy EF,Belzberg AJ

    更新日期:2001-09-01 00:00:00

  • Minimally invasive superficial temporal artery to middle cerebral artery bypass through an enlarged bur hole: the use of computed tomography angiography neuronavigation in surgical planning.

    abstract::The authors describe their minimally invasive technique for performing a superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, which relies on an enlarged bur hole (2-2.5 cm) rather than the standard craniotomy. They perform this procedure in a minimally invasive fashion, using CT angiography for i...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/JNS/2008/109/9/0553

    authors: Coppens JR,Cantando JD,Abdulrauf SI

    更新日期:2008-09-01 00:00:00

  • Asymptomatic subdural chondrosarcoma. Case report.

    abstract::This report describes a large, asymptomatic, subdural skeletal-type condrosarcoma originating from the meninges. Distinction between the mesenchymal and skeletal types of intracranial chondrosarcoma is important since they have different prognoses. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1978.48.5.0825

    authors: Alvira MM,McLaurin RL

    更新日期:1978-05-01 00:00:00

  • Morphological parameters as factors of 12-month neurological worsening in surgical treatment of patients with unruptured saccular intracranial aneurysms: importance of size ratio.

    abstract:OBJECTIVE:It is well known that larger aneurysm size is a risk factor for poor outcome after surgical treatment of unruptured saccular intracranial aneurysms (USIAs). However, the authors have occasionally observed poor outcome in the surgical treatment of small USIAs and hypothesized that size ratio has a negative imp...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2018.4.JNS173221

    authors: Matsukawa H,Kamiyama H,Kinoshita Y,Saito N,Hatano Y,Miyazaki T,Ota N,Noda K,Shonai T,Takahashi O,Tokuda S,Tanikawa R

    更新日期:2018-09-21 00:00:00

  • The Wilhelm tell technique for anterior lumbar interbody fusion. Technical note.

    abstract::Experience indicates that stand-alone cages may lack the necessary stability to secure highly unstable motion segments at the lumbosacral junction. The authors have designed a special carbon fiber composite interbody cage that allows additional screw placement in anterior lumbar interbody fusion procedures performed a...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/spi.2003.98.2.0222

    authors: Markwalder TM,Wenger M,Elsig JP,Laloux E

    更新日期:2003-03-01 00:00:00

  • Cognitive functioning early after surgery of gliomas in eloquent areas.

    abstract:OBJECT:Patients with gliomas frequently have cognitive deficits, and surgery can exacerbate these deficits. Preoperative assessment is therefore crucial in patients undergoing surgery for glioma in eloquent areas, because the proximity of functional areas increases the risk of permanent postoperative cognitive disturba...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2012.7.JNS12263

    authors: Satoer D,Vork J,Visch-Brink E,Smits M,Dirven C,Vincent A

    更新日期:2012-11-01 00:00:00

  • Subcutaneous sacrococcygeal ependymoma with inguinal lymph node metastasis. Case report.

    abstract::A patient with a subcutaneous sacrococcygeal ependymoma and metastasis to the inguinal lymph nodes is presented and his treatment is described. Previous reports on sacrococcygeal ependymoma are reviewed. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.68.3.0474

    authors: Kramer GW,Rutten E,Sloof J

    更新日期:1988-03-01 00:00:00

  • Successful surgical treatment of an odontogenic ossified craniopharyngioma. Case report.

    abstract::A large, highly ossified craniopharyngioma was diagnosed and surgically treated in a 2-year-old girl. About 20 teeth were macroscopically identified in the operative specimen, some of them totally developed, complete with crown and root. Pathological study established the diagnosis of craniopharyngioma with formation ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.55.5.0832

    authors: Alvarez-Garijo JA,Froufé A,Taboada D,Vila M

    更新日期:1981-11-01 00:00:00

  • Prostaglandin metabolism in experimental cerebral vasospasm.

    abstract::Experimental cerebral vasospasm was produced in the canine basilar artery by an intracisternal injection of fresh autogenous arterial blood, and prostaglandins generated in spastic and nonspastic arteries were assessed by thin-layer chromatography. Prostaglandins synthesized in normal arteries were 6-keto-prostaglandi...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1981.55.5.0779

    authors: Maeda Y,Tani E,Miyamoto T

    更新日期:1981-11-01 00:00:00

  • Deep brain stimulation outcomes in patients implanted under general anesthesia with frame-based stereotaxy and intraoperative MRI.

    abstract::OBJECTIVEThe authors' aim in this study was to evaluate placement accuracy and clinical outcomes in patients who underwent implantation of deep brain stimulation devices with the aid of frame-based stereotaxy and intraoperative MRI after induction of general anesthesia.METHODSThirty-three patients with movement disord...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2017.7.JNS171166

    authors: Matias CM,Frizon LA,Nagel SJ,Lobel DA,Machado AG

    更新日期:2018-12-01 00:00:00

  • Penetration of recombinant interleukin-2 across the blood-cerebrospinal fluid barrier.

    abstract::Recombinant interleukin-2 (rIL-2) is an immunotherapeutic agent with efficacy against certain advanced cancers. The penetration of rIL-2 across the blood-cerebrospinal fluid (CSF) barrier was studied in 12 cancer patients who had no evidence of tumor involvement of the central nervous system. At different times during...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1988.69.1.0029

    authors: Saris SC,Rosenberg SA,Friedman RB,Rubin JT,Barba D,Oldfield EH

    更新日期:1988-07-01 00:00:00

  • Traumatic aneurysms and arteriovenous fistulas of intracranial vessels associated with penetrating head injuries occurring during war: principles and pitfalls in diagnosis and management. A survey of 31 cases and review of the literature.

    abstract::In the early days of the war between Iran and Iraq, reports of the sudden deaths of soldiers who previously had survived a penetrating head injury suggested the possibility that a late complication, traumatic aneurysm (TA), could be the cause of this catastrophe. In response, the authors planned a prospective study to...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1996.84.5.0769

    authors: Amirjamshidi A,Rahmat H,Abbassioun K

    更新日期:1996-05-01 00:00:00

  • Nevus of Ota associated with meningeal melanosis and intracranial melanoma. Case report.

    abstract::A case is reported of a patient in whom an intracranial extracerebral melanoma developed in association with a life-long nevus of Ota. Melanotic pigmentation of the skull, periosteum, and meninges beneath the nevus was found at operation. ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1983.58.2.0280

    authors: Sagar HJ,Ilgren EB,Adams CB

    更新日期:1983-02-01 00:00:00

  • A microsurgical study of the anatomy and course of the ophthalmic artery and its possibly dangerous anastomoses.

    abstract:OBJECT:The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). METHODS:The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cada...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.2007.106.1.142

    authors: Perrini P,Cardia A,Fraser K,Lanzino G

    更新日期:2007-01-01 00:00:00

  • Stenotic and occlusive disease of the venous drainage system of deep brain AVM's.

    abstract::Angiograms obtained prior to treatment in 53 cases of deep-seated cerebral arteriovenous malformations (AVM's) were retrospectively analyzed with particular attention to the topography of the AVM nidus and the venous drainage. The location of the lesion was determined by a combination of angiography and computerized t...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1985.63.2.0180

    authors: Viñuela F,Nombela L,Roach MR,Fox AJ,Pelz DM

    更新日期:1985-08-01 00:00:00

  • Treatment by specialist surgical neurooncologists improves survival times for patients with malignant glioma.

    abstract:OBJECT:Surgeries for CNS tumors are frequently performed by general neurosurgeons and by those who specialize in surgical neurooncology. Subspecialization in neurosurgical practice has become common and may improve patient morbidity and mortality rates. However, the potential benefits for patients of having their surge...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/2014.10.JNS132057

    authors: Khan UA,Bhavsar A,Asif H,Karabatsou K,Leggate JR,Sofat A,Kamaly-Asl ID

    更新日期:2015-02-01 00:00:00

  • The effect of atherosclerosis on endothelium-dependent relaxation in the aorta and intracranial arteries of rabbits.

    abstract::The effect of hypercholesterolemia on vascular responsiveness was studied in isolated rabbit arteries. The arteries of animals maintained on a cholesterol-rich (1%) diet for 6 months had more pronounced intimal lesion than those receiving the diet for 3 months. The aortas were more severely damaged than the carotid or...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3171/jns.1989.70.5.0793

    authors: Kanamaru K,Waga S,Tochio H,Nagatani K

    更新日期:1989-05-01 00:00:00