Cost-Effective Approach to the Laparoscopic Appendectomy: Balancing Disposable Instrument Cost With Operative Time. Issue 6 (June 2020)

• Record Type: Journal Article
• Authors: DeMare, Alexander M.; Luehmann, Natalie C.; Kawak, Samer; Abbott, Emily E.; Long, Jordan; Akay, Begum; Brahmamdam, Pavan; Iacco, Anthony A.; Novotny, Nathan M.
• Is Part Of: American surgeon. Volume 86:Issue 6(2020)
• Page Start: 715
• Page End: 720
• Publication Date: 2020-06
• Subjects: laparoscopic appendectomy -- cost analysis -- disposable instruments -- operative efficiency -- healthcare cost -- cost reduction initiative; Surgery -- Periodicals; Surgery -- United States -- Periodicals; 617.0973
• DOI: 10.1177/0003134820923337
• Languages: English
• ISSNs: 0003-1348

Abstract

Background: Surgeons can help reduce health care spending by selecting affordable and efficient instruments. The laparoscopic appendectomy (LA) is commonly performed and can serve as a model for improving health care cost. Methods: We retrospectively reviewed all adult patients who underwent LA for non-perforated appendicitis from March 2015 to November 2017. Our objective was to determine which combination of disposable instruments afforded the lowest total operative cost without compromising postoperative outcomes. Results: In total, 1857 consecutive patients were reviewed from 2 hospitals. After determining the 8 most commonly utilized combinations of disposable instruments, 846 patients were ultimately analyzed. The combination of a LigaSure, Endoloop, and an EndoBag (LEB) had the shortest median operative time (25 minutes, P < .001) and lowest median total operative cost ($1893, P < .001). Conclusions: The LEB instrument combination rendered the shortest operative time, lowest total operative cost, and can be used to maximize surgical value during LA.