A cost and performance evaluation of disposable and reusable biopsy forceps in GI endoscopy

Background: Biopsy forceps are widely used in gastrointestinal endoscopy, a nd yet few data exist on the usage and costs associated with disposable ver sus reusable forceps. Methods: We prospectively measured the costs and operational performance of disposable and reusable forceps in 200 biopsy sessions; 100 sessions were performed using disposable forceps and 100 sessions were performed using re usable forceps. Total cost per use of the reusable forceps, including acqui sition costs plus the costs of reprocessing per established guidelines, was determined. At the end of the study, the reusable forceps were disassemble d to determine the cause of mechanical failures. Results: The total cost per use of the disposable forceps was $38. For the reusable forceps, the acquisition cost per forceps was $415 and the total r eprocessing cost was $16.56 +/- 0.07 per forceps. For 10, 15 and 20 uses, r eusable forceps costs were $58.06, $44.23, and $37.31, respectively. Reusab le forceps malfunction at 11 to 15 uses was 5%; at 16 to 20 uses was 25%; a nd at 21 to 25 uses reached 80% (p < 0.001). Dismantling of the reusable fo rceps at the end of the study demonstrated coiled sheath kinking, rust in t he forceps closure mechanism, bent spikes, and biomaterial contamination. Conclusions: Up to 15 to 20 uses, disposable and reusable forceps costs wer e similar. If reusable forceps are used more than 20 times, then they are l ess expensive. However, in this range of uses, reusable biopsy forceps perf ormance diminishes. With disposable biopsy forceps costing less than $40, c ost differences between reusable and disposable forceps are minimal.