Cost comparison of reusable and single-use ultrasonic shears for laparoscopic bariatric surgery

Use of ultrasonic shears is currently the standard for advanced laparoscopic digestive surgery. The costs of medical care continue to increase, yet the amount of evidence-based information on cost differences in reusable and single-use equipment is scarce.

All bariatric laparoscopic cases in our division that required the use of ultrasonic shears were observed during a 7-month period. The reusable and single-use scalpels were alternated weekly. Associated expenses (replacements, cleaning, sterilization), blood loss, complications, and ease-of-use were assessed. The total cost and cost per case for the two types of scalpels were calculated and compared.

Eighty-five cases with both the single-use and reusable scalpels were evaluated. Both groups of cases were comparable in type of surgeries and patient demographics. No significant difference in operation time (reusable, 156 +/- 15 min; single-use, 174 +/- 15 min; p = 0.34) or ease-of-use was noted. The equipment failure rate (one replacement each), complications, and estimated blood loss (reusable, 63 +/- 11 mL; single-use, 83 +/- 12 mL; p = 0.06) were similar. A total cost saving of $15,163 resulted from the use and processing of the reusable equipment. Using the reusable shears for 85 cases, the cost-per-case saving was $196.40.

The reusable scalpel had a cost saving over single-use scalpel that increased with the number of cases. The reusable scalpel resulted in significant cost savings without impact on complication rate and ease-of-use.