Endoscopic extraperitoneal inguinal hernioplasty: disposable and reusable instruments

Endoscopic totally extraperitoneal inguinal hernioplasty, TEP, has become an established technique for repair of inguinal hernia. The performance of TEP usually requires a number of disposable instruments. The high cost of these devices has been a deterrent to development of laparoscopic surgery. Success in cost containment is pivotal to enhance a wider application of TEP and benefit more patients, particularly in public hospitals. The differences in the design and material of disposable and reusable instruments account for distinction in their handling and safety attributes. Replacement of disposable instruments by reusable ones sometimes requires modification of surgical techniques. Reusable instruments are economically advantageous, but they require sterilization. Wear and tear of these reusable tools after multiple procedures sometimes causes unexpected problems during operation. This chapter reviews the pros and cons of reusable and disposable instruments for performance of TEP. The selection of reusable or disposable instruments should balance the cost of the procedure, convenience of the operation theatre, safety of the patient, and experience of the surgeon. Instruments, whether reusable or disposable, should offer value for money.