title: Cost assessment of instruments for single-incision laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed as conventional laparoscopic 4-port cholecystectomy or as single-incision laparoscopic cholecystectomy.
  
  
  METHODS
  Two consecutive series of patients undergoing single-incision laparoscopic cholecystectomy were assessed: (1) single-incision cholecystectomy using a commercially available multichannel port (n=80) and (2) a modified single-incision cholecystectomy using 2 regular trocars inserted through the umbilicus (n=20) with transabdominal sutures for gallbladder mobilization (puppeteering technique). Patients who underwent conventional 4-port cholecystectomy during the same time period (n=100) were selected as controls.
  
  
  RESULTS
  The instrumental cost of the single-incision cholecystectomy using a commercial port was significantly higher (median, $1123) than the cost for conventional 4-port (median $441, P < .0005) and modified single-incision cholecystectomy (median $342, P < .0005). The cost of the modified single-incision procedure was significantly lower than that for the 4-port cholecystectomy (P < .0005).
  
  
  CONCLUSIONS
  The modified single-incision procedure using 2 regular ports inserted through the umbilicus can be performed at lower cost than conventional 4-port cholecystectomy.
authors: Dept. of Surgery K, Bispebjerg Hospital, Copenhagen, Denmark. nadiahenriksen@gmail.com
authors: Nadia A
authors: NA
authors: Henriksen
authors: Haytham
authors: H
authors: Al-Tayar
authors: Jacob
authors: J
authors: Rosenberg
authors: Lars Nannestad
authors: LN
authors: Jorgensen
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000191:economics* / Q000295:instrumentation; D003365:Costs and Cost Analysis; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D020706:Laparoscopes / Q000191:economics*; D014472:Umbilicus