REUSABLE INSTRUMENTS ARE MORE COST-EFFECTIVE THAN DISPOSABLE INSTRUMENTS FOR LAPAROSCOPIC CHOLECYSTECTOMY

Health care costs are rising rapidly, and surgeons can play a role in limiting costs of operations. Of the 600,000 cholecystectomies perform ed each year in the United States, approximately 80% are performed wit h laparoscopic technique. The purpose of this study was to compare the costs of reusable vs disposable instruments used during laparoscopic cholecystectomy. The costs to the hospital of reusable and disposable instruments were obtained. Instruments studied were the Veress needle, trocars and sleeves (two 10 mm and two 5 mm), reducers, clip appliers , and clips. In addition, the costs of sterilization and sharpening fo r reusable instruments were calculated. The cost of reusable instrumen ts was based on an assumed instrument life of 100 cases. Data from thr ee private hospitals and a Canadian university hospital were collected and examined. Data from the four hospitals revealed that the costs of reusable instruments per case were $46.92-$50.67. The comparable cost s for disposable instruments were $385.28-$515.48. The advantage was t hus $330.00-$460.00 per case. Theoretical advantages of disposable ins truments such as safety, sterility, and better efficiency are not born e out in literature review. In addition, the environmental impact of i ncreased refuse from disposable instruments could not be exactly defin ed. With the consideration of significant cost savings and the absence of data demonstrating disadvantages of their use, reusable instrument s for laparoscopic cholecystectomy are strongly recommended.