title: Reusable instruments are more cost-effective than disposable instruments for laparoscopic cholecystectomy.
abstract: Health care costs are rising rapidly, and surgeons can play a role in limiting costs of operations. Of the 600,000 cholecystectomies performed each year in the United States, approximately 80% are performed with laparoscopic technique. The purpose of this study was to compare the costs of reusable vs disposable instruments used during laparoscopic cholecystectomy. The costs to the hospital of reusable and disposable instruments were obtained. Instruments studied were the Veress needle, trocars and sleeves (two 10 mm and two 5 mm), reducers, clip appliers, and clips. In addition, the costs of sterilization and sharpening for reusable instruments were calculated. The cost of reusable instruments was based on an assumed instrument life of 100 cases. Data from three private hospitals and a Canadian university hospital were collected and examined. Data from the four hospitals revealed that the costs of reusable instruments per case were $46.92-$50.67. The comparable costs for disposable instruments were $330.00-$460.00 per case. Theoretical advantages of disposable instruments such as safety, sterility, and better efficiency are not borne out in literature review. In addition, the environmental impact of increased refuse from disposable instruments could not be exactly defined. With the consideration of significant cost savings and the absence of data demonstrating disadvantages of their use, reusable instruments for laparoscopic cholecystectomy, are strongly recommended.
authors.affiliation: Department of Surgery, Michigan State University, East Lansing 48824.
authors.forename: K N
authors.initials: KN
authors.lastname: Apelgren
authors.forename: M L
authors.initials: ML
authors.lastname: Blank
authors.forename: C A
authors.initials: CA
authors.lastname: Slomski
authors.forename: N S
authors.initials: NS
authors.lastname: Hadjis
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000191:economics* / Q000295:instrumentation*; D003362:Cost-Benefit Analysis; D004209:Disposable Equipment / Q000191:economics*; D017743:Equipment Reuse / Q000191:economics*; D006801:Humans; D010865:Pilot Projects