Comparison of economic and environmental impacts between disposable and reusable instruments used for laparoscopic cholecystectomy

Adler, Samuel N.; Scherrer, M; Rückauer, K; Daschner, Franz

doi:10.1007/s00464-003-9232-4

Cited by 84 publications

(54 citation statements)

References 5 publications

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“…Other papers in this category report on current reuse and reprocessing practices in different medical facilities and regions [13][14][15], while others focus more on logistical and implementation aspects of reprocessing [16,17]. Several studies have examined the costs and benefits of reusable devices versus disposable devices [18][19][20], and while they touch on some related issues, they do not directly address the question posed by this paper. First, they do not address the issue of reprocessing, which involves reusing devices which are labeled as disposable.…”

Section: Relevant Literaturementioning

confidence: 93%

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Sloan

2006

Health Care Manage Sci

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Healthcare expenditures in the US are approaching 2 trillion dollars, and hospitals and other healthcare providers are under tremendous pressure to rein in costs. One cost-saving approach which is gaining popularity is the reuse of medical devices which were designed only for a single use. Device makers decry this practice as unsanitary and unsafe, but a growing number of third-party firms are willing to sterilize, refurbish, and/or remanufacture devices and resell them to hospitals at a fraction of the original price. Is this practice safe? Is reliance on single-use devices sustainable? A Markov decision process (MDP) model is formulated to study the trade-offs involved in these decisions. Several key parameters are examined: device costs, device failure probabilities, and failure penalty cost. For each of these parameters, expressions are developed which identify the indifference point between using new and reprocessed devices. The results can be used to inform the debate on the economic, ethical, legal, and environmental dimensions of this complex issue.

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Section: Relevant Literaturementioning

confidence: 93%

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Sloan

2006

Health Care Manage Sci

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“…This study, along with others, concludes that most reusable instruments should be used given the cost advantage, unless an obvious benefit from disposable equipment is thought to be present by the surgeon. 4 Results of this study may be explained by the make of the scissors. The Direct Drive was significantly more effective in cutting through the staple line and proved to be more durable after this rigorous testing.…”

Section: Discussionmentioning

confidence: 80%

Laparoscopic Scissors: A Subjective and Objective Comparison of Three Brands

Harper

Figueroa²,

Ebrahimi³

et al. 2009

Journal of Endourology

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“…Furthermore, accompanying advancements in medical technology using endoscopes, new devices have been developed that pose a problem in sterilization (Wilkinson et al 1998). Recently, there is an increasing awareness of environmental control and the impact of waste management in the field of endoscopy (Adler et al 2004;Koh and Kojima et al Kawahara 2005). Therefore, we attempted to apply HACCP to the management of waste generated from the endoscopy unit of Hospital X since December 2004.…”

Section: Implementation Of Haccp In the Risk Management Of Medical Wamentioning

confidence: 97%

Implementation of HACCP in the risk management of medical waste generated from endoscopy

Kojima

Kato

Wang

et al. 2008

Journal of Risk Research

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Medical waste poses health hazards, increases the environmental load and is costly to dispose of. To solve the above problems, we applied the hazard analysis and critical control point system (HACCP) to the management of wastes generated from endoscopy. First, the wastes in three hospitals were quantified. The number and weight of waste per case differed significantly among the three hospitals. Second, HACCP was applied to the endoscopy unit of Hospital X for a year. Wastes were segregated into five types and weighed. We found that 25.8% of 'infectious waste' was in fact 'non-infectious waste' and 'non-infectious plastic waste'. The numbers of needles and needle caps did not correspond in two occasions (needle-loss rate: 0.42%). Bacterial counts of the waste container were determined to investigate infection hazard. The counts were 0 cfu/cm 2 in all examinations except one occasion. The waste control manifests were reviewed, and all entries were consistent with the waste sent for disposal. In Hospital X where implementation of HACCP was attempted, reduction of environmental load and cutting of disposal cost are anticipated by changing the categories of waste segregation. The results suggest that hospital wastes should be managed more safely by HACCP.

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Comparison of economic and environmental impacts between disposable and reusable instruments used for laparoscopic cholecystectomy

Abstract: Considering the upward pressure of costs in hospitals, disposable instruments should be used for laparoscopic cholecystectomy only if they offer clear advantages over reusable instruments.

Cited by 84 publications

References 5 publications

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Laparoscopic Scissors: A Subjective and Objective Comparison of Three Brands

Implementation of HACCP in the risk management of medical waste generated from endoscopy

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