Bare Bones Laparoscopy: A Randomized Prospective Trial of Cost Savings in Laparoscopic Cholecystectomy

Abstract

The "bare bones" protocol is safe. It has a short learning curve, demonstrates a cost advantage over the common method, and requires no additional operative time. Pain, time to return to work, and satisfaction are equivalent.

Systematic review of reusable versus disposable laparoscopic instruments: costs and safety

“…Four main methods of saving costs have been described: Reusing disposables, which is technically feasible but not approved in most countries due to concerns about sterility and the clinical consequence of residual viral load Using other techniques which eliminate the use of laparoscopic instruments . For instance Morrison et al .…”

“…Therefore, there is a high incentive to decrease costs while minimizing complications . Some methods of cost savings include using reusable clip appliers, not opening the suction/irrigation, not opening the endo‐bag unless spillage has occurred, preventing the need for a Foley catheter insertion and eliminating the use of 2 × 6 mm disposable trocars in the right flank …”

“…4 Some methods of cost savings include using reusable clip appliers, not opening the suction/irrigation, not opening the endo-bag unless spillage has occurred, preventing the need for a Foley catheter insertion and eliminating the use of 2 × 6 mm disposable trocars in the right flank. 2 In a large prospective study of 1803 LC patients, disposable set costs per procedure were found to be 6.4× greater than reusable sets which included trocars, ports and clip applicators. 12 Sterilization costs were factored in this study.…”

“…In the past two decades, huge technological advances have revolutionized surgical procedures particularly in laparoscopic surgery . Increasingly sophisticated and refined instruments have been developed for laparoscopic procedures, with a trend for investment by major manufacturers in improving the generally preferred single‐use rather than reusable instruments …”

“…1 Increasingly sophisticated and refined instruments have been developed for laparoscopic procedures, with a trend for investment by major manufacturers in improving the generally preferred singleuse rather than reusable instruments. [1][2][3] Often disposable products are seen as more economical due to significantly lower market prices and diminished or absent requirements for sterilization and maintenance. 3 Controversy, however, has arisen with respect to the adverse environmental impact of single-use instruments.…”