Title

Application of rules 1 to 6 for maximizing government infrastructure utilization in laparoscopic cholecystectomy: A case series analysis

Authors

Anil Kumar¹*, ShaguftaNaaz², Ravi Shekhar³, AbhyudayKumar², ShivKishor³ & Rekha Kumari¹

Affiliation

¹Department of Trauma Surgery & Critical Care, All India Institute of Medical Sciences, Patna, India; ²Department of General Anaesthesia, All India Institute of Medical Sciences, Patna, India; ³Department of General Surgery, All India Institute of Medical Sciences, Patna, India; *Corresponding author

Email

Anil Kumar - E-mail: dranil4@gmail.com
ShaguftaNaaz - E-mail: drshaguftanaaz@gmail.com
Ravi Shekhar - E-mail: ravishekhar1oct@gmail.com
AbhyudayKumar - E-mail: drabhyu@gmail.com
ShivKishor - E-mail: shiv110r@gmail.com
Rekha Kumari - E-mail: dr.rekha11636@aiimspatna.org

Article Type

Research Article

Date

Received October 1, 2025; Revised October 31, 2025; Accepted October 31, 2025, Published October 31, 2025

Abstract

Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstone disease, but long waiting lists are common in India due to high disease prevalence and limited government resources. Therefore, it is of interest to evaluate a two-operation room (OR) model to optimise resource utilisation, in which patient preparation in one OR was overlapped with surgical steps in another OR. A total of 64 patients were operated on over three days, with an average operative time of 24.45 minutes per case; significantly more surgeries were completed in 6 hours with the new model (21.3 cases) compared to routine practice (6.3 cases in 8 hours, p<0.05). Most patients were female (98%), with a mean age of 44.8 years and operative times ranged from 9 to 55 minutes. The “1–6 rule” (1 consultant, 2 ORs, 3 assistants, 4 anaesthetists, 5 nursing/support staff and 6 hours of surgery) may be an innovative policy strategy for maximising LC efficiency in government hospitals.

Keywords

Laparoscopic; cholecystectomy; LC; 1 to 6 rules; GSD; government hospital;

Citation

Kumar et al. Bioinformation 21(10): 3855-3860 (2025)

Edited by

Neelam Goyal & Shruti Dabi

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.