title: Comparison of economic and environmental impacts between disposable and reusable instruments used for laparoscopic cholecystectomy.
abstract: BACKGROUND
  The economic and environmental effects were compared between disposable and reusable instruments used for laparoscopic cholecystectomy. Special consideration was given to the processing of reusable instruments in the Miele G 7736 CD MCU washer disinfector and the resultant cost of sterilization.
  
  
  METHODS
  The instruments frequently used in their disposable form were identified with the help of surgeons. Thus, of all the instruments used for laparoscopic cholecystectomy, the disposable and reusable versions of trocars, scissors, and Veress cannula were compared.
  
  
  RESULTS
  For the case examined in this study, the performance of laparoscopic cholecystectomy with disposable instruments was 19 times more expensive that for reusable instruments. The higher cost of using disposable instruments is primarily attributable to the purchase price of the instruments. The processing of reusable instruments has little significance in terms of cost, whereas the cost for disposing of disposable instruments is the least significant factor. The number of laparoscopic cholecystectomies performed per year does not substantially influence cost. In the authors' opinion, assessment of the environmental consequences shows that reusable instruments are environmentally advantageous.
  
  
  CONCLUSIONS
  Considering the upward pressure of costs in hospitals, disposable instruments should be used for laparoscopic cholecystectomy only if they offer clear advantages over reusable instruments.
authors.affiliation: Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Hugstetterstrasse 55, 79106, Freiburg, Germany. stefan.adler@uniklinik-freiburg.de
authors.forename: S
authors.initials: S
authors.lastname: Adler
authors.forename: M
authors.initials: M
authors.lastname: Scherrer
authors.forename: K D
authors.initials: KD
authors.lastname: Rückauer
authors.forename: F D
authors.initials: FD
authors.lastname: Daschner
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000191:economics* / Q000295:instrumentation*; D003365:Costs and Cost Analysis; D003862:Depreciation; D004203:Disinfection / Q000191:economics / Q000295:instrumentation; D004209:Disposable Equipment / Q000191:economics*; D017743:Equipment Reuse / Q000191:economics; D005858:Germany; D006801:Humans; D013242:Sterilization / Q000191:economics; D013525:Surgical Instruments / Q000191:economics; D014866:Waste Products
chemical_list: D014866:Waste Products