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Mario Nutis, M.D., FACOGIn this era of reform, where surgeons must strive for both positive patient and financial outcomes, many are turning to reposable laparoscopic instrumentation. Consisting of a selection of reusable handpieces that utilize a broad assortment of disposable tips, a reposable platform is perfectly positioned to meet the clinical and economic demands of today’s – and tomorrow’s - healthcare environment. In fact, hospitals typically incur a third of the cost when using reposable instruments versus fully disposable instruments.[1]

High Quality Instruments Equate to High Quality Care

The greatest benefit of a reposable platform is the clinical precision it provides compared with fully disposable or fully reusable instrumentation. Because disposable laparoscopic instruments are designed for single use, they are cheaply made and don’t offer the surgeon the tactile feel and high performance required for advanced procedures. On the other hand, fully reusable devices, where the handle and tips are intended for multiple use, must undergo the cleaning, disinfection and sterilization process, which can compromise their integrity.

At one time or another, most surgeons have been handed fully reusable instruments that have gone through the autoclave only to find the scissors don’t cut properly or the grasper doesn’t grasp tissue effectively. If duplicates of these instruments are not available in the OR, the surgeon must either wait for the new ones to arrive, or, in the worst-case scenario, use what they have to the best of their ability. One of the advantages of a reposable platform is that the surgeon always has a new instrument tip that works as the manufacturer intended.

A reusable, high-quality hand piece also offers clinical benefits. Tactile feel is critical when performing complex procedures through small incisions with limited visibility to the surgical site. Cheaply made, plastic disposable handles don’t provide the palpable, physical feedback required when manipulating tissue and other structures within the body. With a reposable system that features an ergonomically designed handle comprised of a durable and resilient polymer, a surgeon can easily “feel” the patient’s anatomy through the instrument.

Driving Greater Efficiency in the OR

The OR is the revenue-generating center for a hospital. While patient safety is the number one priority, the ability to increase OR efficiency is an important consideration, particularly at a time when organizations are facing increased costs coupled with declining profits.

A reposable platform contributes to greater procedural efficiency in a number of ways. For example, having a reusable handle with a range of disposable tips versus multiple instruments means OR staff can set up the case cart more quickly. Also, when the surgeon is performing a case and determines that he/she needs different instrumentation, it’s much faster and easier for staff to procure what is required.

Reducing Cost and Waste

A clear cost advantage of using a reposable system versus a fully disposable instrument is the facility need only purchase the tips for a particular case while the handpiece gets used for many more cases. A typical hospital performs an average of 2,000 laparoscopic procedures annually and during each procedure, the surgeon uses approximately three different instruments. Since disposable devices can cost $90 or more, a typical hospital spends approximately $540,000 annually on such instruments.[2]

Another benefit relates to disposal costs. It is estimated that ORs are responsible for 20 to 30 percent of total hospital waste. The use of disposable supplies and equipment[3] and packaging materials used to maintain device sterility contribute to this waste.

During the course of many procedures, OR staff open instruments that go unused. For fully disposable instruments, the hospital must either absorb the cost of that instrument or pass it along to the patient because once that device is out of its packaging, it is no longer sterile. A reposable platform reduces costs by giving the hospital and surgeon much more control. If staff open a tip that goes unused, the cost of that action is a fraction of what it would have been for a full instrument.

Conclusion

Reposable instruments enable surgeons to perform advanced procedures with efficacy and safety, while lowering costs and reducing waste for facilities. They address the economic needs of healthcare providers today while ensuring the surgeon has the highest quality instrumentation in his/her hands to care for the patient. This approach benefits everyone.

 

[1] Data on file, Microline Surgical

[2] Data on file, Microline Surgical

[3] Greening the Operating Room: Reduce, Reuse, Recycle and Redesign: http://www.asahq.org/For-Members/Clinical-Information/Greening-the-Operating-Room.aspx

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