Optimizing operating room efficiency in robotic-assisted total knee arthroplasty through manufacturing efficiency principles

IF 2.7 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-05-26 DOI:10.1002/jeo2.70283

Akito Hiraoka, Bart Swinnen, Aline Vandeputte, Willem Franssen, Geert Leirs

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Abstract

Purpose

Recent studies have explored the application of manufacturing efficiency principles as a framework for improving operating room (OR) throughput, quality of care and patient outcomes. However, these principles have not yet been validated with real-world research data. In this study, we investigated whether applying these principles has an impact on the operational excellence and teams' consistency of robotic-assisted total knee arthroplasty (RATKA) procedures.

Methods

A total of 31 patients, divided over eight surgery days, were included in the study. The aim of the study was to answer the research question: ‘Does applying efficiency principles have an impact on the operational excellence of RATKA surgery?’ The efficiency of the procedures was monitored using the artificial intelligence (AI)-enabled camera application and analyzed utilizing an AI-backed process digital twin platform. Normally distributed continuous variables were compared using the independent t test. Equality of variances was assumed using the Levene's test for equality of variances. Non-normally distributed continuous variables were analyzed using the Mann–Whitney U test.

Results

After analyzing the baseline group, four procedural modifications were implemented according to the lean principles. There was a significant difference in preparation time (mean difference = 4.3, 95% confidence interval = 1.3–7.3, p = 0.007), showing the efficiency gain during preparation after efficiency implementation. The number of sets opened per case was reduced from ten to seven sets.

Conclusions

Findings indicate that better OR preparation, consistent staff allocation and effective staff training can reduce surgical times, minimize waste and improve OR throughput. Addressing primary constraints, parallelizing flows and breaking down processes decreases surgical wait times, enhances patient flow and streamlines OR operations.

Level of Evidence

Level III.

Abstract Image

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通过制造效率原则优化机器人辅助全膝关节置换术的手术室效率

目的最近的研究探讨了制造效率原则作为提高手术室（OR）吞吐量、护理质量和患者预后的框架的应用。然而，这些原则尚未得到现实世界研究数据的验证。在本研究中，我们调查了应用这些原则是否对机器人辅助全膝关节置换术（RATKA）手术的操作卓越性和团队一致性产生影响。方法选取31例患者，分8天进行手术治疗。该研究的目的是回答研究问题：“应用效率原则对RATKA手术的卓越操作有影响吗？”“程序的效率使用人工智能（AI）支持的相机应用程序进行监控，并使用人工智能支持的过程数字孪生平台进行分析。正态分布的连续变量采用独立t检验进行比较。使用Levene的方差相等检验假设方差相等。非正态分布的连续变量采用Mann-Whitney U检验进行分析。结果在对基线组进行分析后，根据精益原则实施了4项程序修改。术前准备时间差异有统计学意义（平均差异为4.3,95%可信区间为1.3 ~ 7.3,p = 0.007），说明术前准备过程中效率提高。每箱打开的套数从10套减少到7套。结论更好的手术室准备，一致的人员配置和有效的人员培训可以减少手术次数，减少浪费，提高手术室吞吐量。解决主要限制，并行流程和分解流程减少手术等待时间，增强患者流程并简化手术室操作。证据等级三级。

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