title: Educating surgeons may allow for reduced intraoperative costs for inguinal herniorrhaphy.
abstract: BACKGROUND
  Our aim was to determine the impact of surgeon education regarding disposable supply costs to reduce intraoperative costs for a common procedure such as inguinal hernia repair.
  
  
  METHODS
  At the end of the 2013 fiscal year (FY 13), surgeons in our department were provided with information about the cost of disposable equipment and implants used in common general surgery operations. Surgeons who historically had lower supply costs demonstrated individual techniques to their colleagues. No financial incentive or punitive measures were used to encourage behavior change. Surgical supply costs for laparoscopic and open inguinal hernia repair in FY13 were then compared with costs during fiscal year 2014 (FY14) using Mann-Whitney U tests.
  
  
  RESULTS
  The average cost of laparoscopic inguinal hernia repairs decreased from an average $1,088±473 (±SD) in FY13 (n=258) to $860±441 (n=274) in FY14 after surgeon education, representing a 21.0% reduction in intraoperative costs (p<0.001). The most impactful adjustments to reduce costs included selective use of mesh fixation devices (22.9%) and balloon dissecting trocars (27.6%), reduction in use of disposable scissors (13.8%), and reduction in use of disposable clip appliers (3.7%). Open inguinal hernia costs were reduced from an average (±SD) of $315±$253 in FY13 (n=366) to $288±$130 in FY14 (n=286), an 8.6% reduction in cost (p<0.01). In these cases, both avoiding the use of fixation devices and using less expensive mesh implants were identified as significant factors.
  
  
  CONCLUSIONS
  Surgeon education and empowerment may significantly reduce the cost of disposable equipment in laparoscopic and open inguinal hernia repair. This simple educational technique could prove financially beneficial throughout various procedures and disciplines.
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
authors: Yalini
authors: Y
authors: Vigneswaran
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
authors: John G
authors: JG
authors: Linn
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL.
authors: Matthew
authors: M
authors: Gitelis
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
authors: Joseph P
authors: JP
authors: Muldoon
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL.
authors: Brittany
authors: B
authors: Lapin
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
authors: Woody
authors: W
authors: Denham
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL.
authors: Mark
authors: M
authors: Talamonti
authors: Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, University of Chicago, Chicago, IL. Electronic address: mujiki@northshore.org.
authors: Michael B
authors: MB
authors: Ujiki
mesh_terms: D000328:Adult; D000368:Aged; D003363:Cost Control; D004209:Disposable Equipment / Q000191:economics*; D004502:Education, Medical, Continuing; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D059685:Herniorrhaphy / Q000191:economics* / Q000193:education / Q000295:instrumentation / Q000379:methods; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois; D010535:Laparoscopy / Q000191:economics / Q000193:education / Q000295:instrumentation; D008875:Middle Aged; D066231:Surgeons / Q000193:education*; D013526:Surgical Mesh / Q000191:economics