[Do costs decide? Disposable or reusable instruments in laparoscopic cholecystectomy?].

UNLABELLED: Laparoscopic cholecystectomy requires new and specially designed instruments. Both, disposable and reusable instruments are available and frequently used. The purpose of this analysis was to compare these instruments with regard to safety and costs. A complete and detailed calculation comprising all cost components was performed using data from 534 patients. SAFETY of the procedure was assessed by the documentation of all events during and after laparoscopic cholecystectomy in 1000 consecutive patients. COSTS: A standard operation with reusable instruments costs DM 3395. One third of these costs are non-hospital costs. Every postoperative day in hospital adds DM 234.44, every minute of operation time adds DM 4.88. Using a complete of disposable instruments causes an increase in total costs of DM 1117, which mainly results from the costs of the instruments themselves. SAFETY: Among 1000 operations all performed with reusable instruments, 82.3% were uneventful for the patient. The wound infection rate was 2.3%. Until today no injuries of the staff caused by these instruments were observed. These findings demonstrate that reusable instruments are safe and cost-effective.