Introduction

In our current medical climate, the efficient use of medical resources is of prime importance. Unfortunately, this places the onus on medical care providers to develop measures to promote cost containment and reduce redundancy. This is a commonly shared theme in other fields such as engineering and business.

For example, let us look at the semiconductor chip design industry. Over the last 10 years, there has been an explosion in the ability to increase the complexity and density of semiconductor circuitry. This has driven the need to develop more cost effective and efficient methods to fabricate and test these chips.

Engineers have developed specialized fabrication and testing protocols to enhance the efficiency of these processes. The use of such protocols diminishes redundancy.

Similar techniques can also be applied to medicine. The use of clinical pathway protocols in the management of patients has been shown to provide significant cost containment and enhance efficiency in the use of medical resources (1,2).

Koch and Smith (2) presented some very elegant work in demonstrating cost containment by the use of a standardized clinical pathway protocol in the management of post-radical prostatectomy patients. This consolidated the use of such protocols at several institutions around the country. Flickinger et al. (1) demonstrated the beneficial use of clinical pathways in the management of pediatric ureteroneocystostomy patients.

This opens the door to a whole range of possibilities. The application of such protocols in patients that undergo laparoscopic or minimally invasive procedures is likely to have similar benefits. The design of current clinical protocols is usually based on the average or typical patient for that particular scenario. However, as we all know, not every patient is identical.

In the silicon chip fabrication process, not every wafer develops in an identical fashion. Thus, there are complex readjustment protocols that tailor the fabrication process to the specific requirements of that particular wafer.

Similarly, it only seems logical to design "smart" clinical pathway protocols that would readjust to a particular patient's needs to better suit the scenario.

Mathematical prediction modeling could be incorporated into such clinical pathways to provide this "intelligence."

RESULTS

Laparoscopic Radical/Simple Nephrectomy: Lesser or Greater Than Two Days Duration of Hospital Stay Predictor Laparoscopic Radical/Simple Nephrectomy: Lesser or Greater Than One Day Duration of Hospital Stay Predictor Laparoscopic Partial Nephrectomy: Greater or Lesser Than Two Days Duration of Hospital Stay Predictor Laparoscopic Partial Nephrectomy: Greater or Lesser Than One Day Duration of Hospital Stay Predictor THE FUTURE REFERENCES

Engineers have developed specialized fabrication and testing protocols to enhance the efficiency of these processes. The use of such protocols diminishes redundancy.

The use of clinical pathway protocols in the management of patients has been shown to provide significant cost containment and enhance efficiency in the use of medical resources.

It only seems logical to design "smart" clinical pathway protocols that would readjust to a particular patient's needs to better suit the scenario.

This is but one example of the potential use of mathematical modeling in medicine. This chapter is dedicated to the discussion and presentation of mathematical modeling techniques and solutions in the field of laparoscopic or minimally invasive urology.

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