Implementation of a Safe Cost Reduction Strategy for Laparoscopic Sleeve Gastrectomy.

Area of Science:

• Bariatric Surgery
• Surgical Quality Improvement
• Healthcare Economics

Background:

• Operating room disposable supply costs represent a significant financial burden in bariatric procedures.
• Sleeve gastrectomy, a common bariatric surgery, presents opportunities for cost reduction initiatives.

Purpose of the Study:

• To evaluate the financial impact of implementing a phased cost-reduction strategy for disposable supplies during sleeve gastrectomy.
• To assess the safety and efficacy of modified stapling techniques and supply usage on patient outcomes.

Main Methods:

• A quality improvement initiative was conducted involving 638 laparoscopic sleeve gastrectomies.
• The strategy involved transitioning from routine use of expensive staplers and buttressing to less costly staplers with selective use of staple line reinforcements and clip appliers.

Main Results:

• Initial switch to a single-fire stapler showed no cost savings.
• Subsequent transition to a less costly stapler with selective reinforcement and clip applier use resulted in significant cost savings of $1,283 per case (95% CI: $1,216 to $1,351).
• No significant differences were observed in length of stay, 30-day weight loss, or rates of reoperation or readmission.

Conclusions:

• Selective use of surgical supplies, including clip appliers and staple line reinforcements, can lead to substantial cost savings in sleeve gastrectomy.
• Adopting cost-reduction strategies in the operating room is feasible without compromising patient safety or surgical outcomes.