Implementation of a Safe Cost Reduction Strategy for Laparoscopic Sleeve Gastrectomy

We conducted a quality improvement initiative aimed at reducing operating room disposable supply costs during sleeve gastrectomy.

We implemented a cost reduction strategy for all sleeve gastrectomy operations at a single center which involved switching from ECHELON+ stapler with routine use staple line buttressing to a single-fire stapler (Titan SGS) to standardize the amount of staple reloads and afterwards, switching to the easyEndoLite stapler with shorter staple heights and selective use of staple line reinforcements and clip appliers.

We included 638 cases of primary laparoscopic sleeve gastrectomy performed from January 2020 to June 2024. There were no significant differences in the total operating room supply costs after switching to a single-fire stapler, but after switching to a less costly stapler and selectively using staple line reinforcements and clip appliers, we demonstrated a cost savings of $1,283 (95% confidence interval [CI]: $1,216 to $1,351) per case (P < .001), without any differences in length of stay or 30-day weight loss or risk of reoperation or readmission.

During sleeve gastrectomy, surgeons should consider adopting operating room cost-reduction strategies such as selective use of clip appliers, judicious usage of staple line reinforcement material, and choosing less costly stapler devices.