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A cost-effectiveness evaluation of laparoscopic disposable versus nondisposable infraumbilical cannulas
S B Ransom1, S G McNeeley, C White
1Department of Obstetrics and Gynecology, Henry Ford Health Systems, Eastern Region, 131 Kercheval, Grosse Point Farms, MI 48236, USA.
Study Objective:
To compare the safety and cost-effectiveness of disposable and nondisposable infraumbilical laparoscopic cannulas.
Design:
Retrospective review of consecutive laparoscopic procedures performed from July 1, 1988, to June 30, 1994.
Setting:
A university-affiliated hospital. Patients. The 10,459 consecutive women who underwent laparoscopies.
Interventions:
A 10-mm disposable cannula was used in 529 laparoscopies and a nondisposable cannula in 9930, based on physician preference.
Measurements And Main Results:
The only intraabdominal injuries associated with insertion of disposable and nondisposable cannulas were bowel injuries in one and three patients, respectively. The injury rates for the instruments were 19 and 3/10,000 cases, respectively, but were not statistically different (P <0.05, Fisher's two-tail exact test). The hospital cost per disposable cannula in 1994 was $63.71; the cost per procedure with the nondisposable cannula was amortized and was less than $1.35, including maintenance.
Conclusion:
Disposable cannulas were not cost effective and were associated with a higher but not statistically significant complication rate. Therefore, the more expensive disposable cannulas are not recommended.