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A system for determining elapsed time for a surgical procedure conducted using an endoscope is disclosed. The system may be configured to determine elapsed time for management overseeing operating rooms to determine performance metrics of the operating room such as, but not limited to, operating room consistency and frequency of unusual procedure times to assess operating room efficiency. The system may include determining insertion of an endoscope into a patient and determining removal of the endoscope from a patient. The system may then generate an elapsed surgery time based upon the insertion time of the endoscope into the patient and the removal time of the endoscope from the patient.