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Technology In Practice

Implant And Instrument Inventory System Offers Improved Efficiency And Convenience In The OR

Could a new surgical suite inventory system, complete with surgical hardware, revolutionize the availability, accessibility and safety of surgical implants?

Gramercy Extremity Orthopedics recently launched the GEO CART®, a computerized mobile implant and instrument inventory system. Powered by radio frequency identification (RFID) technology, the GEO CART helps trace and manage the pre-sterilized, single-use implant or instrument from selection to operative use and generates reports for the patient record. At the end of each day, the GEO CART will run an automatic physical inventory and create a cloud-networked pick ticket for the warehouse to send needed items to the facility for replenishment. The cart can hold over 2,000 items and is no larger than a standard medical cart, according to the company. 

The company notes that the goals of GEO CART include providing a more cost-effective, time-effective and user-friendly way to provide surgical implants and instruments while also enhancing patient safety. Surgeons and facilities may note reduced surgical delays, less billing mistakes, less handwritten forms and less instrument or item loss in the sterilization and inventory process.

Gabriel V. Gambardella, DPM, FACFAS, a consultant for Gramercy Extremity Orthopedics, states that the GEO CART is advancing the materials process in operating rooms, preventing increased tourniquet time, anesthesia time, surgery time and undesirable outcomes from a change in surgical plan, or risks such as infection. He also adds that the circulator and OR nurse can spend more time focused on patient well-being and safety. 

Christopher Hyer, DPM, FACFAS, a consultant for Gramercy Extremity Orthopedics, agrees. After using the system in an ambulatory surgery center (ASC) for 15 months, he feels it is very intuitive and efficient, and points out that one can run multiple cases simultaneously from the cart. 

“Also, since the cart lives in the ASC, it makes it easier to coordinate the case and not rely on trays being shipped in or delivered on time by surgical reps,” points out Dr. Hyer, who is board-certified in foot surgery and reconstructive ankle and hindfoot surgery.

Over the past two to three years, David Caminear, DPM, FACFAS, has utilized the GEO CART in the ASC environment and inpatient and outpatient hospital ORs. A consultant for Gramercy Extremity Orthopedics, Dr. Caminear recalls using the cart for a variety of cases, including bunionectomies, hammertoes, Lisfranc fracture-dislocations, midfoot fractures, triple arthrodesis and ankle fusion.

“The GEO CART is innovative in the RFID technology, its ease of use and simplicity for the surgeon and in the seamless restocking of cart materials,” says Dr. Caminear, who is in practice with Connecticut Orthopaedics in Hamden, Ct. 

The company adds that the GEO CART may contain several of GEO’s surgical hardware systems including the patent-pending nitinol GEO Staple, the titanium GEO Bone Screw and the GEO Hammertoe Screw. 

Drs. Gambardella and Hyer share that their experiences with GEO implants have been positive, citing the quality and reliability of the products. Regarding quality, Dr. Caminear feels this is related to the guaranteed sterility of each individual single-use pack so one does not have to worry about any flaws in the sterilization of a large instrument tray. Dr. Gambardella specifically notes that he and his residents have yet to experience stripping of the bone screws after use in a multitude of forefoot and rearfoot procedures. He relates mostly using the GEO Staple as adjuvant fixation or compression but notes the staple’s ease of insertion. Dr. Caminear agrees that the GEO Staple is unique in its design and ease of use. Intraoperative adjustability and an integrated implantation system are features that make the GEO Hammertoe Screw unique, according to Dr. Gambardella, who is in private practice in Bloomfield, Ct. 

Dr. Gambardella also feels there is relevance and impact for this system in a health care climate that is steadily shifting toward value-based care, stressing that the value of treatment and accountability for results are increasingly differentiating successful from struggling providers. 

“From a surgical point of view,” explains Dr. Gambardella, “Gramercy Extremity Orthopedics is providing a platform for each foot and ankle surgeon to increase the value of his or her care through their groundbreaking concept, while also setting the template to allow others involved in the operating room to focus on patient care.”

Technology In Practice
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By Jennifer Spector, DPM, FACFAS, Associate Editor
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