REUSE OF DISPOSABLE LAPAROSCOPIC INSTRUMENTS - COST-ANALYSIS

OBJECTIVE: TO evaluate the cost benefits of reusing disposable laparos copic instruments. DESIGN: A cost-analysis study based on a review of laparoscopic and thoracoscopic procedures performed between August 199 0 and January 1994, including analysis of disposable instrument use, p urchase records, and reprocessing costs for each instrument. SETTING: The general surgery department of a 461-bed teaching hospital where di sposable laparoscopic instruments are routinely reused according to in ternally validated reprocessing protocols. METHODS: Laparoscopic and t horacoscopic interventions performed between August 1990 and January 1 994 for which the number and types of disposable laparoscopic instrume nts were standardized. MAIN OUTCOME MEASURES: Reprocessing cost per in strument, the savings realized by reusing disposable laparoscopic inst ruments and the cost-efficient number of reuses per instrument. RESULT S: The cost of reprocessing instruments varied from $2.64 (Can) to $4. 66 for each disposable laparoscopic instrument. Purchases of 10 common ly reused disposable laparoscopic instruments totalled $183 279, and t he total reprocessing cost was estimated at $35 665 for the study peri od. Not reusing dis posable instruments would have cost $527 575 in in strument purchases for the same period. Disposable laparoscopic instru ments were reused 1.7 to 68 times each. CONCLUSIONS: Under carefully m onitored conditions and strict guidelines, reuse of disposable laparos copic and thoracoscopic instruments can be cost-effective.