many unused instruments had to
be re-sterilized and turned over if
they were only going to go unused
again.
"Historically, in surgery, there's
been this attitude that you want
to have everything that the sur-
geon might possibly need for
every case," says Dr. Sinha, "but
the reality is the surgeons only
use a very small number of
instruments."
His team calculated that each
instrument cost a nickel to
reprocess and sterilize. Spending a
nickel to take care of unused
instruments adds up to 2 full-time
equivalents over the course of a
year. Wouldn't you rather have 2
useful full-time employees on
hand in the OR than a pile of use-
less instruments? Or you could
pocket the savings to the tune of
$120,000 per year.
Dr. Sinha's nursing manager then
asked the logical question. What if
you do need an instrument that isn't
included in your handful of tools?
And what if you drop something?
His team came up with a handy
7 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J u l y 2 0 1 8
For every total knee replacement
he performs, Raj Sinha, MD,
PhD, an orthopedic surgeon at
STAR Ortho in Rancho Mirage,
Calif., uses only 20 instruments.
2 4-prong rakes
1 uSA retractor
2 towel clips
1 Bonney forceps
1 Adson forceps
1 needle driver
1 Smillie retractor
1 2-prong retractor
1 single-prong sharp Hohmann
retractor
1 blunt Hohmann retractor
1 lamina spreader
1 mallet
1 ½ inch curved osteotome
1 Kocher
1 rongeur
1 caliper
1 impactor
1 patella clamp
NO MORE, NO LESS
Dr. Sinha's Barebones
Instrument Set
Raj Sinha,
MD, PhD
