A prospective cost analysis of laparoscopic cholecystectomy

Traverso, L. William; Hargrave, K.

doi:10.1016/s0002-9610(99)80205-0

Cited by 50 publications

(13 citation statements)

References 3 publications

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“…Cost analysis of operating theaters has shown that more than half of the budget is spent on equipment, with more than 80% of this being allocated to the purchase of disposable supplies. 18 Sacrospinous fixation is one of the most widely performed prolapse procedures among UK surgeons for the management of primary and recurrent vault prolapse. 19 On analysis of the British Society of Urogynaecologists database, we found that 574 sacrospinous procedures were performed between 2007 and 2010.…”

Section: Discussionmentioning

confidence: 99%

Responsibility toward affordable healthcare: disposable versus reusable methods for pelvic floor repair

Pandeva

Johnson

Slack

et al. 2018

IJWH

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BackgroundThe adverse publicity surrounding the use of mesh for correction of pelvic organ prolapse has driven a renewed interest in native tissue repair. Established techniques used reusable instruments, while recent innovations have generally involved disposable equipment. Here, we compare outcomes between the two techniques used for sacrospinous ligament fixation for the correction of apical prolapse: Miya Hook (reusable) and Capio® (single-use) suturing devices.MethodsA prospective cohort study of women undergoing vaginal sacrospinous colpopexy or hysteropexy was undertaken. The patients were assessed preoperatively and 1 year post-operatively. The primary outcomes were improvement in vaginal scores and patient-reported absence of a vaginal bulge. Secondary outcomes included impact on sexual function, quality of life, perioperative complications and apical recurrence. The cost of instruments, operative times and length of stay were analyzed.ResultsIn total, 133 women with advanced prolapse in the apical compartment underwent colpopexy or hysteropexy (63 using the reusable Miya Hook and 40 with the disposable Capio device). Mean follow-up was 16.9 months (SD 7.8) and 14 months (SD 3.1), respectively. There were no significant differences in baseline characteristics or preoperative Pelvic Organ Prolapse Quantification staging between the two cohorts. Significant improvements in vaginal scores, sexual function and quality of life (International Consultation on Incontinence Questionnaire – Vaginal Symptoms) were observed in both groups postoperatively (P<0.01). Both groups had low apical recurrence in the medium term (<3%). There were no significant differences in operative times or length of stay. The use of disposable equipment was associated with higher cost.ConclusionSacrospinous fixation using either the Miya Hook or the Capio device is equally effective for the management of apical prolapse. In the absence of clinical benefit, the choice of instrument should reflect the cost in a financially constrained health-sector environment.

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Section: Discussionmentioning

confidence: 99%

Responsibility toward affordable healthcare: disposable versus reusable methods for pelvic floor repair

Pandeva

Johnson

Slack

et al. 2018

IJWH

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“…Much discussion has occurred in the past regarding the advantages and disadvantages of reusable versus disposable instruments [17]. The rationale behind initial skepticism against RLIs included not only high acquisition and maintenance cost, but also issues of possible transmission of infectious disease to patients and medical personnel, instrument inefficiency, and lack of durability [18, 19].…”

Section: Discussionmentioning

confidence: 99%

“…The fact remains though that instrumentation cost is only a fraction of total hospital costs per patient [17]. For a sustainable health care management, a comprehensive approach to cost-effectiveness should also combine ambulatory protocols, targeted preoperative patient assessment, and standardized enhanced recovery pathways.…”

Section: Discussionmentioning

confidence: 99%

Reducing the Cost of Laparoscopy: Reusable versus Disposable Laparoscopic Instruments

Manatakis

Georgopoulos

2014

Minimally Invasive Surgery

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Cost-effectiveness in health care management is critical. The situation in debt-stricken Greece is further aggravated by the financial crisis and constant National Health System expense cut-downs. In an effort to minimize the cost of laparoscopy, our department introduced reusable laparoscopic instruments in December 2011. The aim of this study was to assess potential cost reduction of laparoscopic operations in the field of general surgery. Hospital records, invoice lists, and operative notes between January 2012 and December 2013, were retrospectively reviewed and data were collected on laparoscopic procedures, instrument failures, and replacement needs. Initial acquisition cost of 5 basic instrument sets was €21,422. Over the following 24 months, they were used in 623 operations, with a total maintenance cost of €11,487. Based on an average retail price of €490 per set, projected cost with disposable instruments would amount to €305,270, creating savings of €272,361 over the two-year period under study. Despite the seemingly high purchase price, each set amortized its acquisition cost after only 9 procedures and instrument cost depreciated to less than €55 per case. Disposable instruments cost 9 times more than reusable ones, and their high price would almost equal the total hospital reimbursement by social security funds for many common laparoscopic procedures.

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“…In a landmark study on the cost analysis of laparoscopic cholecystectomy, it was concluded that the areas in which hospitals and surgeons can improve the surgical value package (i.e., decrease costs while maintaining quality) are disposable equipment, and efficient reduction in the theatre time. [3] Hospitals can maximize their returns on minimally invasive surgery by providing ample training to the surgical and processing staff, by standardizing equipment, by wisely choosing when to use custom kits, block scheduling for minimally inversive surgery (MIS) and incorporating MIS into the hospital's strategic plan. [4] According to Traverso, the concept of increasing value by increasing quality without an attempt to decrease costs is a very important principle that the health care system must learn in our everchallenging medical environment.…”

Section: Discussionmentioning

confidence: 99%

Surgical packages for laparoscopic surgery

Bhattacharya

2005

J Min Access Surg

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‘Packages’ are in fashion today for most surgical procedures in various corporate hospitals and this has included laparoscopic procedures too. A package system enables the hospitals to get cost settlements done more easily. Also, it is more convenient for the patients who are aware upfront of the charges. The principal disadvantages seems to be for the surgeon, who may face displeasure of the patient, hospital or insurance agencies apart from forfeiting his personal charges if (a) he is a novice in laparoscopic surgery and takes extra time to complete a procedure, (b) unforeseen problems occur during surgery, or (c) new pathologies are discovered on exploration.

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A prospective cost analysis of laparoscopic cholecystectomy

Cited by 50 publications

References 3 publications

Responsibility toward affordable healthcare: disposable versus reusable methods for pelvic floor repair

Responsibility toward affordable healthcare: disposable versus reusable methods for pelvic floor repair

Reducing the Cost of Laparoscopy: Reusable versus Disposable Laparoscopic Instruments

Surgical packages for laparoscopic surgery

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