Annual Report 2019

Surgical center

Hiroyuki Fujimoto, Tetsufumi Sato, Kazumi Ishii

Introduction

 In our Surgical Center, surgery is performed by 15 different oncologic surgical departments; bone marrow harvesting for transplantation, and endoscopic therapy and radiation therapy are performed under anesthetic management. Our multidisciplinary surgical team includes surgeons, anesthesiologists, nurses, clinical engineering technologists, pharmacists, medical lab technicians, and clerks and we all cooperate to strive for the best surgical care.

The Team and What We Do

 During the period from April 2019 to March 2020, the Surgical Center supported 5611 surgical cases. 5178 cases took place under the management of the anesthesiology department and 5158 of them were performed under general anesthesia (Table 1 and 2).

Table1. Number of operations (2019.4-2020.3)

Table 2. Number of anesthesia cases (2019.4-2020.3)

 Since the MRI surgical room started operating in 2011, a few cases have taken place every week mainly by neurosurgery. The da Vinci Xi Robotic Surgical System was first introduced for prostate surgery in 2012, followed by rectal cancer surgery in 2014 and esophageal surgery in 2018. In December 2019, we introduced another da Vinci Xi for gynecology and gastric surgery.

 Our top mission is to provide safety for patients; “Safe Surgery Saves Lives”. Five to seven clinical engineering technologists are deployed in the Surgical Center on a full-time basis to inspect and facilitate the medical equipment. Over the past years, surgeries using laparoscopy and thoracoscopy have increased and clinical engineering technologists have set up endoscopic equipment. Their role covers setting up da Vinci, radiofrequency ablation of breast cancer surgery, neurologic monitoring, and so forth.

 We generalized the WHO Surgical Safety Checklist, and thoroughly perform surgical site marking. Also, multidisciplinary meetings have been held for complicated cases since 2015.

 In order to maximize the operational efficiency of our Surgical Center through the perioperative period, we adopted “ORSYS”, the surgical and anesthesia recording system, to share and record data electrically, and the cost of each surgery and each department is calculated with other divisions of our hospital. Moreover, a “one patient one instrument preparation cart system” is used to lighten nurses’ workloads, and nurses specializing in the surgical instruments are allocated.

 For open operation of the Surgical Center, we share information such as operation times, OR occupancy time, the number of overtime surgeries, and other matters with the members. We also make a list of overtime and emergency surgeries to check their validity and problems at the meeting of chief surgeons.

Education

 We accepted not only Japanese residents but also over 75 foreign residents visiting our Surgical Center.

Future prospects

 We will commit to improving the efficiency of all divisions and departments to aim for better quality of the Surgical Center and to increase the number of surgical cases to 6000 with a 6-year plan by 2023.