An investigation into the cost-effectiveness of re-usable instrumentation in minimal access surgery.
Maharaj, S. R.
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This study was an investigation into the cost-effectiveness of using re-usable instrumentation in laparoscopic surgery. The model used for the study was the laparoscopic cholecystectomy which is the commonest laparoscopic procedure performed by the general surgeons. The study was done at KZNGOV Hospital in Kwazulu Natal, one of the largest tertiary hospitals in the province. The research done was both qualitative and quantitative. An exploratory study was conducted initially by drawing up the case study, and then quantitative and qualitative research was conducted to evaluate the use of re-usable instrumentation in laparoscopic surgery. In order to conduct a more focused design, the three most commonly used laparoscopic instruments were evaluated. These were the trocars (sizes 11.0mm and 5.0mm), the endoshears / scissors and the clip applicators. The study aimed to assess whether the use of the re-usable instruments was more cost-effective, whether their use in minimal access surgery was feasible, and whether the use of re-usable instrumentation compromised patient well-being. Information for the case study was obtained from the hospital notes of the patients who had a laparoscopic cholecystectomy at KZNGOV Hospital, and from interviews with experienced surgeons. The study found that the re-usable instrumentation used at KZNGOV Hospital had no adverse effects on the patients. The Department of Surgery and the theatre committee at this hospital have chosen an excellent and cost-effective protocol for laparoscopic surgery, and the choice of instrumentation cannot be faulted. Analysis of the results showed a large cost saving obtained by using the re-usable laparoscopic instrumentation, with no adverse patient outcomes.