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Related Experiment Videos

Using outcomes data to justify instituting new technology: a single institution's experience.

P M Starker1,2, B Chinn3

  • 1Overlook Medical Center, Columbia University College of Physicians and Surgeons, New York, NY, USA. pmstarker@att.net.

Surgical Endoscopy
|December 24, 2017
PubMed
Summary
This summary is machine-generated.

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Intraoperative fluorescence imaging with PINPOINT during colorectal surgery significantly reduces anastomotic leaks and complications. This technology proves cost-effective, justifying its investment by decreasing overall patient case costs.

Area of Science:

  • Colorectal Surgery
  • Surgical Technology
  • Medical Imaging

Background:

  • The PILLAR II trial indicated PINPOINT fluorescence imaging is safe and feasible for colorectal surgery.
  • No adverse events or anastomotic leaks were reported with PINPOINT use.
  • The cost-effectiveness of PINPOINT in offsetting complication-related expenses remained undetermined.

Purpose of the Study:

  • To evaluate the clinical outcomes and direct hospital costs associated with intraoperative fluorescence imaging during colectomy.
  • To determine if the use of PINPOINT technology justifies its initial investment through reduced anastomotic complications.

Main Methods:

  • A retrospective analysis of 347 patients undergoing colectomy with primary anastomosis was conducted.
  • Patients were stratified based on the intraoperative use of fluorescence imaging (PINPOINT).
Keywords:
Anastomotic leakColorectal surgeryHospital value propositionIntraoperative fluorescence imagingNSQIPPINPOINT

Related Experiment Videos

  • Clinical outcomes (anastomotic leak/stricture) and direct hospital costs per case were analyzed.

    • Main Results:

    • The PINPOINT group (238 patients) had a lower anastomotic failure rate (0.84%) compared to the non-PINPOINT group (5.5%).
    • Intraoperative assessment using PINPOINT led to changes in resection margins for 4.6% of patients, with no subsequent anastomotic failures.
    • The PINPOINT group incurred lower direct costs per case due to fewer complications.

    Conclusions:

    • Intraoperative fluorescence imaging with PINPOINT validates previous findings and reduces anastomotic failure rates in colorectal surgery.
    • The reduction in direct costs associated with fewer anastomotic failures justifies the investment in PINPOINT technology.
    • Cost-effectiveness was confirmed, with the technology's expense offset after only 143 cases.