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Updated: Feb 8, 2026

Single Port Donor Nephrectomy
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Programmatic change leads to enhanced resource utilization and efficiency in port placement.

Vijay K Venkatesan1, Zachary D McHenry2, Audrey E Ertel2

  • 1Cincinnati Research on Outcomes and Safety in Surgery (CROSS), Department of Surgery, University of Cincinnati School of Medicine, Cincinnati, Ohio; Medical College of Georgia, Augusta University, Augusta, Georgia.

The Journal of Surgical Research
|June 26, 2018
PubMed
Summary

A new program for central venous port (CVP) placement significantly reduced procedure, operating room (OR), and facility times. This systems-level enhancement improved efficiency without increasing complication rates for this common surgical procedure.

Keywords:
Central venous portDeliveryEfficiencyOutcomesResource utilization

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Area of Science:

  • Surgical Procedures
  • Healthcare Systems Improvement
  • Patient Outcomes

Background:

  • Central venous port (CVP) placement is a common surgical procedure performed by various specialists.
  • Previous research indicated surgeon variability, not training, is the primary predictor of CVP placement outcomes.
  • A need existed to evaluate a systematic approach to optimize CVP placement efficiency and patient focus.

Purpose of the Study:

  • To prospectively evaluate a programmatic shift towards a resource-conscious, patient-focused algorithm for CVP placement.
  • To assess the impact of a systems-level program on procedure time, operating room (OR) time, facility time, and complication rates.
  • To compare outcomes of the new programmatic approach with retrospective data from traditional surgical and interventional radiology placements.

Main Methods:

  • Implementation of a systems-level program for efficient CVP placement, with 78 procedures performed by a single surgeon.
  • Prospective data collection on procedure time, total OR time, total facility time, and procedure-related complications.
  • Comparison of prospective data with retrospective cohorts of surgically and interventional radiology-placed CVPs, using chi-square and Wilcoxon rank-sum tests for analysis.

Main Results:

  • The programmatic approach significantly reduced procedural time (median 16 min vs. 26-40 min), OR time (median 36 min vs. 46-70 min), and facility time (median 235 min vs. 299-319 min).
  • Operating room time reductions ranged from 22% to 49% (10-34 min savings).
  • No significant difference in complication rates was observed between the prospective and comparison groups (P = 0.13).

Conclusions:

  • A programmatic change focusing on efficiency and patient-centered outcomes can substantially decrease procedural, OR, and facility times for CVP placement.
  • These improvements were achieved without a statistically significant increase in complication rates.
  • Data-driven, systems-level enhancements can significantly improve ostensibly simple, common operative procedures.