Prioritizing interrupt causes in minimally-invasive surgeries based on identifying causal relations between interrupt causes

Document Type: Research Paper


1 Department of Industrial Engineering, Tarbiat Modares University, Tehran, I.R. Iran

2 Hospital Management Research Center, Tehran University of Medical Sciences, Tehran, I.R. Iran


Laparoscopy or minimally-invasive surgery is a surgical technique in which the surgical operations are performed via a few small incisions. This kind of surgery has fewer complications over open surgery. Finding methods for shortening the time of laparoscopic surgeries can improve operating room efficiency. An approach to shortening the time of laparoscopic surgeries is identifying the interruptions in these surgeries and preventing from their occurrence or reducing the potential of occurrence of the identified interrupt causes. In this paper, the interrupt causes of laparoscopic surgeries are prioritized based on the identified causal relations between interrupt causes.
Research population is the laparoscopic surgeries performed in Hasheminezhad kidney center in May-June 2013. For this purpose, 25 laparoscopic surgeries are observed in this hospital in this time interval. Causal relations among interrupt causes are identified from the gathered data. The main causes are identified and ranked based on Fuzzy TOPSIS method. For prioritizing the interrupt causes, frequency of occurrence, average length, severity degree, the potential of reducing interrupt occurrence and the potential of preventing interrupt occurrence are considered.
Experimental results show that the most important interrupt causes in laparoscopic surgeries are staff shortage or multi-tasking staff, foggy lens, unavailable surgical instruments, dirty lens and finally low-experienced staff. Moreover, sensitivity analysis on criteria weighting show that the mentioned interrupt causes are the five most-important interrupt causes in more than 80% of the evaluated scenarios.
Preventing the occurrence of the most-important interrupt causes can improve the surgical time. If it is not possible, reducing the average length of interrupts caused by the identified main causes can be considered for improvement of the operating room efficiency.


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