Department of Surgery, New York Presbyterian Hospital, Weill College of Medicine of Cornell University, New York, NY 10021, USA.
Obes Surg. 2010 Apr;20(4):512-8. doi: 10.1007/s11695-008-9723-4. Epub 2008 Nov 18.
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.
目前，超声刀的使用是高级腹腔镜消化手术的标准。医疗费用持续上涨，但关于可重复使用和一次性设备成本差异的循证信息却很少。
在 7 个月的时间里，我们部门所有需要使用超声刀的减肥腹腔镜手术都进行了观察。每周交替使用可重复使用和一次性手术刀。评估相关费用（更换、清洁、消毒）、失血量、并发症和易用性。计算并比较两种手术刀的总成本和每例成本。
评估了 85 例使用一次性和可重复使用手术刀的病例。两组病例的手术类型和患者人口统计学特征相似。手术时间（可重复使用，156 +/- 15 分钟；一次性使用，174 +/- 15 分钟；p = 0.34）或易用性无显著差异。设备故障率（各更换一次）、并发症和估计失血量（可重复使用，63 +/- 11 毫升；一次性使用，83 +/- 12 毫升；p = 0.06）相似。使用可重复使用设备可节省 15,163 美元的总费用。使用可重复使用手术刀进行 85 例手术，每例手术节省成本 196.40 美元。
与一次性手术刀相比，可重复使用手术刀具有成本节约优势，且随着病例数量的增加而增加。可重复使用手术刀在不影响并发症发生率和易用性的情况下，可显著节省成本。
