RESUMO
STUDY DESIGN: Data collected from a postutilization questionnaire were used to evaluate the usability of the OfficeSPEC disposable vaginal speculum, specifically the effectiveness, efficiency, and acceptability, in clinical, hospital, and austere environments. RESULTS: Usability data analysis showed the OfficeSPEC speculum had an effectiveness rating of 4.6/5, efficiency rating of 4.5/5, and acceptability rating of 4.6/5; overall usability in deployed environments was favorable. The overall rankings were 3.4 for plastic, 4.2 for metal (p < 0.001), and 4.5 for OfficeSPEC (p < 0.001). Cost analysis of the OfficeSPEC placed the disposable speculum as a reasonable alternative with yearly cost of $129,200, compared to traditional metal ($209,100) and plastic ($319,175). CONCLUSION: By evaluating the OfficeSPEC speculum within a usability framework, it proved to be practical, viable alternative in all environments, particularly in the forward deployed environment.
Assuntos
Equipamentos Descartáveis/estatística & dados numéricos , Hospitais Militares/economia , Instrumentos Cirúrgicos/estatística & dados numéricos , Custos e Análise de Custo , Equipamentos Descartáveis/economia , Feminino , Humanos , Estudos Prospectivos , Instrumentos Cirúrgicos/economia , Inquéritos e Questionários , Estados UnidosRESUMO
OBJECTIVE: Analyze energy-induced damage to the swine vagina during laparoscopic hysterectomy. STUDY DESIGN: Laparoscopic colpotomy was performed in swine using ultrasonic, monopolar, and bipolar energy. Specimens (n = 22) from 13 swine were stained with hematoxylin and eosin and Masson's trichrome for energy-related damage. The distal scalpel-cut margin was used as reference. Energy induced damage was assessed by gynecologic and veterinary pathologists blinded to energy source. RESULTS: Injury was most apparent on Masson's trichrome, demonstrating clear injury demarcation, allowing consistent, quantitative damage measurements. Mean injury was 0 ± 0 µM (scalpel, n = 22), 782 ± 359 µM (ultrasonic, n = 7), 2016 ± 1423 µM (monopolar, n = 8), and 3011 ± 1239 µM (bipolar, n = 7). Using scalpel as the reference, all were significant (P < .001). CONCLUSION: All energy sources demonstrated tissue damage, with ultrasonic showing the least and bipolar the greatest. Further study of tissue damage relative to cuff closure at laparoscopic hysterectomy is warranted.