BACKGROUND: Our goals were to analyze cost and efficiency of performing carpal tunnel release (CTR) in the main operating room (OR) versus the ambulatory setting, and to document the venue of carpal tunnel surgery practices by plastic surgeons in Canada. METHOD: A detailed analysis of the salaries of nonphysician personnel and materials involved in CTR performed in these settings was tabulated. Hospital statistical records were used to calculate our efficiency analysis. A survey of practicing plastic surgeons in Canada documented the venue of CTR performed by most. RESULTS: In a 3-h surgical block, we are able to perform nine CTRs in the ambulatory setting versus four in the main OR. The cost of CTR in the ambulatory setting is $36/case and $137/case in the main OR in the same hospital. Only 18% of Canadian respondents use the main OR exclusively for CTR, whereas 63% use it for some of their cases. The ambulatory setting is used exclusively by 37%, whereas 69% use it for greater than 95% of their cases. The majority of CTR cases (>95%) are done without an anesthesia provider by 73% of surgeons. Forty-three percent use epinephrine routinely with local anesthesia and 43% avoid the use of a tourniquet for at least some cases by using epinephrine for hemostasis. CONCLUSION: The use of the main OR for CTR is almost four times as expensive, and less than half as efficient as in an ambulatory setting. In spite of this, many surgeons in Canada continue to use the more expensive, less efficient venue of the main OR for CTR.
BACKGROUND: Our goals were to analyze cost and efficiency of performing carpal tunnel release (CTR) in the main operating room (OR) versus the ambulatory setting, and to document the venue of carpal tunnel surgery practices by plastic surgeons in Canada. METHOD: A detailed analysis of the salaries of nonphysician personnel and materials involved in CTR performed in these settings was tabulated. Hospital statistical records were used to calculate our efficiency analysis. A survey of practicing plastic surgeons in Canada documented the venue of CTR performed by most. RESULTS: In a 3-h surgical block, we are able to perform nine CTRs in the ambulatory setting versus four in the main OR. The cost of CTR in the ambulatory setting is $36/case and $137/case in the main OR in the same hospital. Only 18% of Canadian respondents use the main OR exclusively for CTR, whereas 63% use it for some of their cases. The ambulatory setting is used exclusively by 37%, whereas 69% use it for greater than 95% of their cases. The majority of CTR cases (>95%) are done without an anesthesia provider by 73% of surgeons. Forty-three percent use epinephrine routinely with local anesthesia and 43% avoid the use of a tourniquet for at least some cases by using epinephrine for hemostasis. CONCLUSION: The use of the main OR for CTR is almost four times as expensive, and less than half as efficient as in an ambulatory setting. In spite of this, many surgeons in Canada continue to use the more expensive, less efficient venue of the main OR for CTR.
Authors: Donald Lalonde; Michael Bell; Paul Benoit; Gerald Sparkes; Keith Denkler; Peter Chang Journal: J Hand Surg Am Date: 2005-09 Impact factor: 2.230
Authors: D W Levine; B P Simmons; M J Koris; L H Daltroy; G G Hohl; A H Fossel; J N Katz Journal: J Bone Joint Surg Am Date: 1993-11 Impact factor: 5.284
Authors: Cassandra L Thiel; Rafaela Fiorin Carvalho; Lindsay Hess; Joelle Tighe; Vincent Laurence; Melissa M Bilec; Mark Baratz Journal: Hand (N Y) Date: 2017-11-28
Authors: Martin R Leblanc; Donald H Lalonde; Achilleas Thoma; Mike Bell; Neil Wells; Murray Allen; Peter Chang; Daniel McKee; Jan Lalonde Journal: Hand (N Y) Date: 2010-11-18
Authors: Jacob E Tulipan; Nayoung Kim; Jack Abboudi; Christopher Jones; Frederic Liss; William Kirkpatrick; Michael Rivlin; Mark L Wang; Jonas Matzon; Asif M Ilyas Journal: J Hand Microsurg Date: 2017-05-22