Optimizing Efficiency in Lumbar Endoscopy: Key Factors Influencing Surgical Times

Introduction: Efficient management of surgical preparation time, surgery duration, and total operating room time (TOR) is crucial in lumbar endoscopic spine surgery to enhance patient care. Analyzing these variables helps pinpoint factors contributing to extended surgical times, identify areas for improvement, and ultimately improve patient outcomes. This study investigates the impact of surgical variables and patient characteristics on operating room times to provide insights for optimizing clinical decision-making and management.

Methods: 81 patients receiving lumbar endoscopic surgeries were identified. Data on surgery, hospital course and outcomes were extracted. Analysis was done by Pearson correlation tests and Forrest plots, and classified p values ≤ 0.05 as significant.

Results: Analysis showed surgeries at L1-L2 to be associated with longer preparation times, surgical times, and TOR times (r=0.245, p=0.029; r=0.292, p=0.009; r=0.316, p=0.004). Transforaminal, rather than interlaminar approach also led to longer preparation times (r=0.249, p=0.026), surgical times (r=0.246, p=0.028) and TOR time (r=0.288, p=0.009). Smokers were likely to have longer preparation times (r=0.237, p=0.034) and the number of levels operated on correlated to longer surgical and TOR times (r=0.298, p=0.007; r=0.261, p=0.02). Intraoperative complications did not increase any surgical time.

Conclusion : Our study highlights that surgeries at L1-L2 and using the transforaminal approach prolong endoscopic spinal surgery across all measured time points. Interestingly, intraoperative complications did not significantly affect the duration of endoscopic procedures, indicating their minimal impact on surgical efficiency. Understanding these factors provides opportunities to streamline surgical processes, reduce operating room time, and enhance overall efficiency in lumbar endoscopic spine surgery.