Safety profile and cost analysis of reused disposable laparoscopic instruments in RSCM

Introduction: Studies regarding laparoscopic procedure has been focused on its cost, durability, upkeeping, and repairment cost, which will be important in the future. Reusing instruments aims to reduce cost without affecting procedure quality, even though reusable instruments are commonly used, but no sufficient data are available regarding to the effects of using reusable instrument to service quality. Methods: The data used on this study were retrospectively collected between January to December 2015. Total sampling method was used to collect data to all patients undergone laparoscopic procedures using resterilized laparoscopic instruments at urology operating rooms Cipto Mangunkusumo General Hospital (RSCM). The resterilized laparoscopic instruments used were harmonic scalpel handpieces, retroperitoneal baloons and pumps, laparoscopic trocars number 5, 10, and 11. Sterilization procedures were performed using plasma method in Sterilization Center RSCM. Results: The study was carried out to 63 patients undergone laparoscopic procedures using resterilized laparoscopic instruments at urology operating rooms in RSCM between January to December 2015. The specimens were swabbed from laparoscopic trocars, retroperitoneal balloon, and harmonic scalpel handpieces. All of the results came negative. Infection rates in trocar laparoscopic wounds was 1.6% and the rate of patients who experienced an increase in temperature greater than 37.5 °C (Fever) after the surgery was 3.2%. We obtained a difference in cost as much as Rp. 2.074.000 (9.7 times less) in the reuse of disposable trocar laparoscopic instruments. The reuse of re-sterilized harmonic handpiece will enable us to save Rp. 8.945.000 (3.5 times less) and last every each of retroperitoneal balloon that thas been sterilized saved us Rp 862.500 (3,5 times less). Conclusion: The reuse of disposable laparoscopic instruments was able to reduce the cost of laparoscopic surgery with low complication rate thus can be safely performed.