title: A cost evaluation methodology for surgical technologies.
abstract: OBJECTIVE
  To create and validate a micro-costing methodology that surgeons and hospital administrators can use to evaluate the cost of implementing innovative surgical technologies.
  
  
  METHODS
  Our analysis is broken down into several elements of fixed and variable costs which are used to effectively and easily calculate the cost of surgical operations. As an example of application, we use data from 86 robot assisted gastric bypass operations made in our hospital. To validate our methodology, we discuss the cost reporting approaches used in 16 surgical publications with respect to 7 predefined criteria.
  
  
  RESULTS
  Four formulas are created which allow users to import data from their health system or particular situation and derive the total cost. We have established that the robotic surgical system represents 97.53 % of our operating room's medical device costs which amounts to $4320.11. With a mean surgery time of 303 min, personnel cost per operation amounts to $1244.73, whereas reusable instruments and disposable costs are, respectively, $1539.69 and $3629.55 per case. The literature survey demonstrates that the cost of surgery is rarely reported or emphasized, and authors who do cover this concept do so with variable methodologies which make their findings difficult to interpret.
  
  
  CONCLUSIONS
  Using a micro-costing methodology, it is possible to identify the cost of any new surgical procedure/technology using formulas that can be adapted to a variety of operations and healthcare systems. We hope that this paper will provide guidance for decision makers and a means for surgeons to harmonise cost reporting in the literature.
authors.affiliation: University of Strasbourg, BETA, Strasbourg Cedex, France, imad.ismail@ihu-strasbourg.eu.
authors.forename: Imad
authors.initials: I
authors.lastname: Ismail
authors.forename: Sandrine
authors.initials: S
authors.lastname: Wolff
authors.forename: Agnes
authors.initials: A
authors.lastname: Gronfier
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swanström
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swantröm
mesh_terms: D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003661:Decision Support Techniques; D004209:Disposable Equipment / Q000191:economics; D006282:Health Personnel / Q000191:economics; D006801:Humans; D010535:Laparoscopy / Q000191:economics*; D018803:Models, Economic; D061646:Operative Time; D065287:Robotic Surgical Procedures / Q000191:economics*