DISPOSABLE VERSUS REUSABLE INSTRUMENTS IN LAPAROSCOPIC SURGERY - A CONTROLLED-STUDY

The instruments for laparoscopic surgery are usually available in a di sposable and in a reusable type. We performed a prospective, randomize d study, based on the most frequent laparoscopic operation, the cholec ystectomy, in order to directly quantify and compare the advantages an d disadvantages of both types of instruments. 158 patients, who planne d to undergo a cholecystectomy, were randomly distributed into two gro ups. 80 patients (group A) underwent surgery with reusable instruments and 78 patients (group B) with disposable instruments. We investigate d the following parameters and compared them for both groups: length o f operation, complications, conversion rate to open surgery, subjectiv e postoperative pain, length of inability to work, technical problems during operation, postoperative hospitalization time, satisfaction of operating room personnel. The analysis of the results demonstrates no difference in the postoperative hospitalization time, in the postopera tive complication rate, subjective pain sensation and postoperative in ability to work. Differences in favour for the group of patients, oper ated with disposable instruments, were found in the conversion rate, i n the length of operation and, statistically significant, in the amoun t of intraoperative problems, caused by instrument-technical reasons. Even if considering the greater expenses in time and personnel costs, operations with reusable instruments are in average 1015 DM cheaper.