Economic considerations in laparoscopic surgery: disposable versus reusable instrumentation.
The subject of the economic considerations involved in using disposable versus reusable instrumentation has become a controversial issue.The economic evaluations performed purely by economists may not ap- peal to the surgeon and may not be applicable in different parts of the world. The quality of disposable instruments and their convenience in laparoscop'ic surgery is not at issue; the controversy, instead, centers on the question of the cost-effectiveness of disposable equipment. High-quality instruments enable safe, sue- cessful operations.' Some instruments are not available in reusable form and the quality of some reusable in- struments (e-g-, laparoscopic scissors) is sometimes questionable, particularly as they are periodically in need of servicing or repair. For a routine cholecystectomy, clips can be mounted on a reusable applier to ligate the cystic duct and artery. This can save considerable cost. However, disposable clips and their appliers should be available in the operating room (OR) in case of emergencies such as uncontrolled bleeding.
Savalgi
R S
RS
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.