AUTHOR=Strobel Rahel M. , Schineis Christian H. W. , Lasierra Viguri Leyre , Stroux Andrea , Eschlböck Sophie M. , Lobbes Leonard A. , Pozios Ioannis , Seifarth Claudia , Weixler Benjamin , Kamphues Carsten , Beyer Katharina , Lauscher Johannes C. 

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

JOURNAL=Frontiers in Surgery

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1141017

DOI=10.3389/fsurg.2023.1141017

ISSN=2296-875X

ABSTRACT=Background
Standardization and digitalization are getting more and more essential in surgery. Surgical procedure manager (SPM®) is a freestanding computer serving as a digital supporter in the operating room. SPM® navigates step-by-step through surgery by providing a checklist for each individual step. 
Methods
This was a single center, retrospective study at the Department for General and Visceral Surgery at Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin. Patients who underwent ileostomy reversal without SPM® in the period of January 2017 until December 2017 were compared to patients who were operated with SPM® in the period of June 2018 until July 2020. Explorative analysis and multiple logistic regression were performed. 
Results
Overall, 214 patients underwent ileostomy reversal: 95 patients without SPM® vs. 119 patients with SPM®. 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®: ten (10.5%) patients vs. four (3.4%) patients; p = 0.035. Multiple logistic regression showed a risk reduction for intraabdominal abscess (Odds ratio (R) 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® in ileostomy reversal.
Conclusions
SPM® provides a digital solution for standardization in the visceral surgery operating room. SPM® may reduce postoperative complications in ileostomy reversal such as intraabdominal abscess and bowel perforation. SPM® led to a significantly higher patient safety in this study.