Bachmann G A, Trattler B, Ko T, Tweddel G
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, New Brunswick 08901-1977, USA.
Obstet Gynecol. 1998 Jul;92(1):142-4.
To reorganize reusable laparoscopic instrumentation to promote instrument accessibility, minimize instrument breakage, eliminate infrequently used instruments on permanent trays, and help control maintenance costs.
The Robert Wood Johnson University Hospital Gynecologic Steering Committee evaluated during a 5-month period the storage, use, and maintenance of gynecologic laparoscopic instrument sets used in the surgical suite. Acting on this data, the committee oversaw the following changes. Infrequently used instruments were removed from permanent trays and separately packaged. Two types of gynecologic laparoscopy trays were prepared: one for laparoscopic bilateral tubal ligations and one for both diagnostic and operative laparoscopy. A double-decker compartmentalized tray in which instruments were sterilized and stored replaced the extant single-layer ones in which instruments were stacked on each other. To facilitate instrument identification and function, a surgical manual was compiled with photographs of each instrument and a description of its use.
After implementation of these changes, maintenance and sterilization costs for a 10-month period were compared with those for the previous 10 months. There was a savings of $13,889. The ratio of total costs divided by number of cases performed during the two study periods was also compared. There was a savings of $31 per case.
Savings were achieved by reorganizing this operating room's handling of reusable gynecologic laparoscopy equipment. By eliminating infrequently used instruments from the permanent trays and by using a double decker compartmentalized tray that was used during surgery, sterilization, and storage, both sterilization costs and maintenance costs were reduced.
重新整理可重复使用的腹腔镜器械，以提高器械的可及性，尽量减少器械损坏，去除永久托盘上不常用的器械，并有助于控制维护成本。
罗伯特·伍德·约翰逊大学医院妇科指导委员会在5个月的时间里评估了手术套房中使用的妇科腹腔镜器械套装的储存、使用和维护情况。根据这些数据，委员会监督了以下改变。不常用的器械从永久托盘中取出并单独包装。准备了两种妇科腹腔镜托盘：一种用于腹腔镜双侧输卵管结扎术，另一种用于诊断性和手术性腹腔镜检查。一种双层分隔托盘取代了现有的单层托盘，在双层托盘中器械进行消毒和储存，而在单层托盘中器械相互堆叠。为便于识别器械及其功能，编写了一本手术手册，其中包含每种器械的照片及其使用说明。
实施这些改变后，将10个月期间的维护和消毒成本与前10个月的进行了比较。节省了13,889美元。还比较了两个研究期间总成本除以手术病例数的比率。每例节省31美元。
通过重新组织该手术室对可重复使用的妇科腹腔镜设备的处理实现了成本节约。通过从永久托盘中去除不常用的器械，并使用在手术、消毒和储存期间使用的双层分隔托盘，消毒成本和维护成本均有所降低。
