Outfitting for the Outpatient Ortho Boom
Between aging Baby Boomers’ growing needs and a strong same-day preference among patients and insurers, the demand for outpatient orthopedic procedures like total knees and...
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By: John Cherf
Published: 10/10/2007
Speed and power. When buying power tools, the more of each, the better. Other factors impact the performance of the tools and the satisfaction of the surgeons who use them, but speed and power top the list. Here's an overview.
How many tools is enough?
Your case mix and case volume will determine how many and what kind of power tools you'll need. If you only do a few procedures a month, then one device with several attachments should be adequate. You can also lend and borrow with other facilities if the need is rare, says Gabrielle White, RN, CASC, the director of the Orthopedic Surgery Center of Orange County, in Newport Beach, Calif.
If you're doing 50 or more cases a month, you'll need at least two or three tools with multiple attachments. Remember that power tools represent a significant investment to your facility, so your budget can also become a determining factor in how many tools you can purchase.
Locate at least three companies and get estimates from each, says Ms. White. After you've evaluated each product, choose the most preferred and best quality, and then work on negotiating the price. "Educate your MDs to never let one vendor know it has the preferred equipment. Otherwise, you have less room to negotiate the price down," Ms. White tells us. "And never pay list price."
Three categories of tools are used in orthopedic, neuro, ENT and oral/maxillofacial procedures.
Purchasing pearls
Here are factors to consider when thinking of buying any of these types of tools.
Power is also an important feature to consider when purchasing any type of power tool. Power produces speed and torque. If speed isn't combined with enough torque, the tool can burn through the bone (torque provides a clean cut at slower speeds). If a tool is underpowered, the surgeon will have to push more on the bone. A lower-powered tool might stall when cutting dense bone, "jump" and injure surrounding soft tissues, or prick the surgeon's finger. An underpowered tool can also cause fatigue because the surgeon must push harder to achieve the desired result. You want the tool to work for you, not vice versa.
Corded electric motors mean lighter weight and easier maneuverability for surgeons in the OR. They're also quieter than pneumatic tools. On the downside, electric tools, like pneumatic ones, are tethered to something - in this case, a control panel. Also keep in mind that there are many ways that an electric tool can fail; the cords, control panels and footswitches will only work properly if the condition and maintenance of the cords and connectors is kept up.
Having a battery-operated tool means that you can rid your surgical field of cords and hoses, which will greatly enhance mobility and sterilization techniques. New advances in battery life are allowing batteries to last from two to five years depending on their type, frequency of use and care. However, the more power a battery-powered instrument has, the heavier they tend to be, and even though the tools may be reliable, you're at the mercy of the batteries being charged and ready.
Balance is another factor to consider. How does the tool feel in the surgeon's hand? The weight should be well distributed and not pull the tool in any direction. This equal weight distribution will help the surgeon keep the tool steady and prevent his having to fight against the tool in long cases.
Also consider the ease of changing attachments on a tool. Some systems use keys to change attachments, which can cost surgeons time in the OR. Newer systems use simple twist-and-lock mechanisms for a quick change of burs during surgery to reduce surgery time and ensure safer procedures.
A few other factors to keep in mind...
The Anspach Effort
XMax
(800) 327-6887
www.anspach.com
Price: Not disclosed
FYI: Anspach's XMax offers the ultimate combination of high power, smooth operation, low noise level and small size, says the company. The Xmax can |handle a complete range of surgical procedures ranging from power-demanding applications to the most delicate dissection. With an operating speed of 80,000 rpm at 90-120 psi input pressure, the Xmax system is the quietest pneumatic motor available, claims the company.
Arthrex
ClearCut Burrs
(800) 934-4404
www.arthrex.com
Price: Not disclosed
FYI: Arthrex's new line of ClearCut Burrs features a clear, high-strength polycarbonate hood covering the cutting surface of the burr tip which allows for increased visibility, says the company. The ClearCut Burr has a reduced size outer tube that allows the user increased access and improved cutting angles while continuing the "no-clog" outer tube design with suction pathways beneath the burr head and another through the outer tube, says Arthrex.
Brasseler USA Surgical
Power and Accessories
PneuMicro Small Bone Power System
(800) 535-6638
www.brasselerusamedical.com
Price: $2,260 to $2,620 price range for each hand piece
FYI: Brasseler's PneuMicro can be used for all small bone procedures to include orthopedic, oral, maxillofacial, otology and podiatric techniques, says the company. The PneuMicro is equipped with a high speed drill, medium speed drill, sagittal saw, oscillating saw, reciprocating saw and a soon-to-be-released wire driver. All handpieces are ergonomically designed, balanced and compact to allow easier access and greater visibility to the smaller working areas.
ConMed Linvatec
Hall Mpower Battery Powered Instruments
(800) 237-0169
www.conmed.com
Price: Not disclosed
FYI: ConMed's Hall Mpower system merges the power needed for the most demanding large bone procedures with a compact and lightweight design that is ideal for delicate hand and foot surgery. In addition to its unique size and performance, the Hall Mpower system is a full sealed powered instrument system that can be cleaned in a washer/sanitizer.
Medtronic
XPS 3000 Powered ENT System
(800) 874-5797
www.medtronicent.com
Price: $10,164 (console and two pumps) $11,464 to $12,010 (Visao High-Speed Otologic Drill) $8,220 (Straightshot M4 Microdebrider)
FYI: Medtronic's XPS 3000 Powered ENT System lets surgeons choose the amount of power needed for various ENT procedures, from high-performance to ultra-low speed oscillation, says the company. The XPS 3000 also offers a wide array of sub-specialty blades and burs, including an ergonomic microdebrider and a water-cooled high-speed otologic drill, and has an intuitive interface that allows OR staff to adjust irrigation levels and bur or blade speed with the touch of a button.
MicroAire Surgical Instruments
MicroAire Battery SmartDriver XT
(800) 722-0822
www.microaire.com
Price: $5,244.75
FYI: MicroAire's SmartDriver features a powerful, long-lasting 14.4-volt nickel metalhydride (NiMH) battery that provides longer run time than conventional NiCd batteries provided with other systems. Its pure power and the versatility it provides for various procedures makes the SmartDriver an excellent choice for a wide range of surgical procedures, says the company. The system also offers a complete compliment of attachments.
OsteoMed
OsteoPower Surgical Handpiece System
(800) 456-7779
www.osteomedcorp.com
Price: Not disclosed
FYI: OsteoMed's OsteoPower Surgical Handpiece System is a high-speed electric power system designed to accommodate a wide range of small bone specialties. The hand control handpiece has surface integrated sensors that let the surgeon control the power level, forward/reverse and speed from the sterile field. In addition, the fully modular system offers not only dual handpiece capabilities, but dual footswitch capabilities as well.
Stryker
System 6 Surgical
Handpieces
(800) 253-3210
www.stryker.com
Price: Not disclosed
FYI: Stryker's sixth-generation battery powered handpieces provide more options for great versatility and surgeon preference, says the company. One handpiece allows for both high speed drilling and high-torque reaming and can be converted to high-torque reaming without changing attachments. The saw attachments provide rotating heads, smaller size and new and improved motors that allow for faster, more efficient cutting action.
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