title: Cost comparison of reusable and single-use ultrasonic shears for laparoscopic bariatric surgery.
abstract: BACKGROUND
  Use of ultrasonic shears is currently the standard for advanced laparoscopic digestive surgery. The costs of medical care continue to increase, yet the amount of evidence-based information on cost differences in reusable and single-use equipment is scarce.
  
  
  METHODS
  All bariatric laparoscopic cases in our division that required the use of ultrasonic shears were observed during a 7-month period. The reusable and single-use scalpels were alternated weekly. Associated expenses (replacements, cleaning, sterilization), blood loss, complications, and ease-of-use were assessed. The total cost and cost per case for the two types of scalpels were calculated and compared.
  
  
  RESULTS
  Eighty-five cases with both the single-use and reusable scalpels were evaluated. Both groups of cases were comparable in type of surgeries and patient demographics. No significant difference in operation time (reusable, 156 +/- 15 min; single-use, 174 +/- 15 min; p = 0.34) or ease-of-use was noted. The equipment failure rate (one replacement each), complications, and estimated blood loss (reusable, 63 +/- 11 mL; single-use, 83 +/- 12 mL; p = 0.06) were similar. A total cost saving of $15,163 resulted from the use and processing of the reusable equipment. Using the reusable shears for 85 cases, the cost-per-case saving was $196.40.
  
  
  CONCLUSIONS
  The reusable scalpel had a cost saving over single-use scalpel that increased with the number of cases. The reusable scalpel resulted in significant cost savings without impact on complication rate and ease-of-use.
authors.affiliation: Department of Surgery, New York Presbyterian Hospital, Weill College of Medicine of Cornell University, New York, NY 10021, USA.
authors.forename: Elliot
authors.initials: E
authors.lastname: Yung
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
authors.forename: Gregory
authors.initials: G
authors.lastname: Dakin
authors.forename: Luca
authors.initials: L
authors.lastname: Milone
authors.forename: Gladys
authors.initials: G
authors.lastname: Strain
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000191:economics* / Q000295:instrumentation; D003365:Costs and Cost Analysis; D004209:Disposable Equipment / Q000191:economics; D017743:Equipment Reuse / Q000191:economics; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013525:Surgical Instruments / Q000191:economics