used during basic procedures such as myringotomies to $100,000 for
high-optic microscopes needed to place cochlear implants and per-
form mastoidectomies. We ultimately paid $75,000 for 2 microscopes.
One was a higher-end model, but because nearly 60% of our proce-
dures are ear tube cases for pediatric patients, we bought a more
basic model for the second OR.
Image guidance is developing into the standard of care for ENT sur-
gery. It's one more tool that helps increase the accuracy and safety of
procedures when anatomical landmarks are distorted by disease. When
we first opened and didn't have an image guidance system, our physi-
cians were performing image-guided sinus procedures at a local hospi-
tal-owned outpatient center. It begged the question, "How many cases
are we sending away and how much revenue are we losing?"
That prompted me to run a cost-analysis on purchasing an image-
guided system, which run about $135,000 to $150,000, depending on
the instruments and options purchased. My calculations showed we
could pay off the system we purchased by performing 38 image-guid-
ed cases within a year. We actually wound up performing 78 cases and
paid it off sooner.
The system, which creates 3D imaging by overlaying 3 different 2D
images from a patient's pre-op CT scans, provides real-time clinical
mapping of sinus cavities to help physicians navigate their instru-
ments through the sinuses. It also has disposable trackers that sur-
geons can attach to their preferred instrumentation.
Time-saving footprint
We focused on efficiency when planning the facility, and that attention
to detail is evident in the final design. The U-shaped layout of the
building was created for maximum patient flow and minimal staff
excursion.
4 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 9
