Cost-effectiveness in health care management is critical. The situation in debt-stricken Greece is further aggravated by the financial crisis and constant National Health System expense cut-downs. In an effort to minimize the cost of laparoscopy, our department introduced reusable laparoscopic instruments in December 2011. The aim of this study was to assess potential cost reduction of laparoscopic operations in the field of general surgery. Hospital records, invoice lists, and operative notes between January 2012 and December 2013, were retrospectively reviewed and data were collected on laparoscopic procedures, instrument failures, and replacement needs. Initial acquisition cost of 5 basic instrument sets was €21,422. Over the following 24 months, they were used in 623 operations, with a total maintenance cost of €11,487. Based on an average retail price of €490 per set, projected cost with disposable instruments would amount to €305,270, creating savings of €272,361 over the two-year period under study. Despite the seemingly high purchase price, each set amortized its acquisition cost after only 9 procedures and instrument cost depreciated to less than €55 per case. Disposable instruments cost 9 times more than reusable ones, and their high price would almost equal the total hospital reimbursement by social security funds for many common laparoscopic procedures. 1. Introduction The wide adoption of the concept of minimally invasive laparoendoscopic surgery and the concomitant progress in technology have reduced the prices of sophisticated laparoscopic instruments; however, cost of laparoscopy remains generally higher than that of open surgery. In most clinical studies, higher operating theatre cost is partly offset by shorter hospital stays, less medication requirements, shorter periods of convalescence, and faster return to work and normal activity [1–6]. On the other hand, multiple cost studies, already from the 1990s, have shown that reusable laparoscopic instruments (RLIs) are a valuable asset for surgical departments in terms of cost reduction [7–15]. In an effort to minimize the cost of laparoscopic surgery, without compromising quality of health services, our department introduced RLIs in December 2011, under the pressure of budget limitation. The primary aim of this study was to assess potential cost reduction of laparoscopic procedures performed between January 2012 and December 2013, in the field of general surgery. The secondary aim was to calculate annual maintenance expenses of RLIs and investigate possible ways of further cost limiting.
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