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Creative Ways to Save Money in the OR - May 2016 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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who now runs a minimally invasive surgical device manufacturer in Columbus, Ohio. "They cut a little bit into the plane of what's reflecting the light. The entire teaching of surgery is how to identify and isolate tissue while operating." Being as sure as possible that you know what you're cutting into is the key to minimizing damage, says Dr. Poll. Keep in mind, however, that each patient's anatomy is, to a certain extent, subject to variabili- ty and ambiguity. "The entire experience of surgery is how to get out of trouble," he adds. "The ability to see things has great value." The ability to see things, and to avoid accidentally nicking or slicing them, is image enhancement technology's contribution to reducing surgical risk and the rate of post-op complications in minimally inva- sive surgery. "It's a cadence to minimize damage to tissue you can't see," says Dr. Poll. The real-time road map it provides of blood ves- sels, ureters, the biliary tree, nerve bundles and other critical anatomy, and the electronic adjustments it provides to brighten and clear that view, offer a major safety benefit over even the soundest techniques. Consider, for example, laparoscopic cholecystectomy's techniques. The rate of common bile duct injuries increased to 0.5% nationally fol- lowing the development and introduction of the lap chole procedure, according to a survey reported in a 2001 issue of the Annals of Surgery (osmag.net/PhyAK6). Santiago Horgan, MD, chief of the minimal- ly invasive surgery division at the University of California San Diego School of Medicine and director of its Center for the Future of Surgery, has described this complication as "the Achilles heel of laparoscopic surgery." "These injuries occur when you don't expect them," he remarked in a demonstration of image enhancement technology at the Society of American Gastrointestinal and Endoscopic Surgeons' annual meeting in March. "Common bile duct injuries never happen when it's difficult. 8 0 • 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 Y 2 0 1 6

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