WILL COSTS DECIDE - DISPOSABLE OR REUSABL E INSTRUMENTS IN LAPAROSCOPIC CHOLECYSTECTOMY

Laparoscopic cholecystectomy requires new and specially designed instr uments. Both, disposable and reusable instruments are available and fr equently used. The purpose of this analysis was to compare these instr uments with regard to safety and costs. A complete and detailed calcul ation comprising all cost components was performed using data from 534 patients. Safety of the procedure was assessed by the documentation o f all events during and after laparoscopic cholecystectomy in 1000 con secutive patients. Costs: A standard operation with reusable instrumen ts costs DM 3395. One third of these costs are non-hospital costs. Eve ry postoperative day in hospital adds DM 234.44, every minute of opera tion time adds DM 4.88. Using a complete set of disposable instruments causes an increase in total costs of DM 1117, which mainly results fr om the costs of the instruments themselves. Safety: Among 1000 operati ons all performed with reusable instruments, 82.3% were uneventful for the patient. The wound infection rate was 2.3%. Until today no injuri es of the staff caused by these instruments were observed. These findi ngs demonstrate that reusable instruments are safe and cost-effective.