A study of added costs of laparoscopic cholecystectomy based on surgery preference cards.

Hospitals are pressured to cut expenses to generate a profit, but many current surgical procedures still fall below a "break-even" point. Laparoscopic cholecystectomy is a high-volume surgical procedure that can be profitable for hospitals if costs are reduced and complications minimized. Our limited liability corporation of independent surgical specialists examined the preference cards of ten surgeons who performed laparoscopic cholecystectomies in August 2000. We wished to determine whether these surgeons differed in their use of disposable equipment and devices for the same surgical procedure. All of the disposable equipment and devices studied were assigned a price by the hospital purchasing department that was representative of the hospital costs and not what was billed to the patient. The sum total of disposable instruments for a single operative case in which laparoscopic cholecystectomy was performed ranged from $92 to $637 (mean $333) depending on the preference of the surgeon. Our study points out the differences in expenses between surgeons. Maintaining this type of expense tracking can apply to other procedures and is a good place to start a surgeon-led and hospital-based cost-saving initiative.