Standardized digital solution with surgical procedure manager (SPM?)-an opportunity for maximizing patient safety and efficiency in ileostomy reversal?

BackgroundStandardization and digitalization are getting more and more essential in surgery. Surgical procedure manager (SPM & REG;) is a freestanding computer serving as a digital supporter in the operating room. SPM & REG; navigates step-by-step through surgery by providing a checklist for each individual step.MethodsThis was a single center, retrospective study at the Department for General and Visceral Surgery at Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin. Patients who underwent ileostomy reversal without SPM & REG; in the period of January 2017 until December 2017 were compared to patients who were operated with SPM & REG; in the period of June 2018 until July 2020. Explorative analysis and multiple logistic regression were performed.ResultsOverall, 214 patients underwent ileostomy reversal: 95 patients without SPM & REG; vs. 119 patients with SPM & REG;. Ileostomy reversal was performed by head of department/attendings in 34.1%, by fellows in 28.5% and by residents in 37.4%; p = 0.91. Postoperative intraabdominal abscess emerged more often in patients without SPM & REG;: ten (10.5%) patients vs. four (3.4%) patients; p = 0.035. Multiple logistic regression showed a risk reduction for intraabdominal abscess {Odds ratio (OR) 0.19 [95% confidence interval (CI) 0.05-0.71]; p = 0.014} and for bowel perforation [OR 0.09 (95% CI 0.01-0.93); p = 0.043] in the group with use of SPM & REG; in ileostomy reversal.ConclusionsSPM & REG; may reduce postoperative complications in ileostomy reversal such as intraabdominal abscess and bowel perforation. SPM & REG; may contribute to patient safety.