67th Annual Meeting Abstracts

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Cost Comparison Of Disposable Equipment Used In Laparoscopic Versus Robot-assisted Laparoscopic Radical Prostatectomy
*Phillip M Pierorazio¹, *William Carruth¹, *Susanna George¹, *Edward M Schaeffer¹, *Frank C Lowe², *Christian P Pavlovich^1
1Johns Hopkins, Baltimore, MD;²St. Lukes Roosevelt-Columbia University, New York, NY

Introduction: The operative cost of radical prostatectomy (RP) has increased as minimally-invasive technology has been successfully applied to RP. Operating room disposables represent variable costs that may differ between minimally-invasive surgical approaches. We chose to compare the costs of disposables used in laparoscopic RP (LRP) and robot-assisted laparoscopic RP (RARP).
Materials & Methods: A review of instruments pulled for LRP and RARP cases at Johns Hopkins Medical Institutions in 2007-08 was performed. Costs for single-use and multi-use disposables were tabulated, and for multi-use disposable costs, were allocated by case volumes. We assessed actual operating room disposable costs rather than final charges.
Results: Per case, RARP was more expensive than LRP. The disposable cost of a typical LRP case was $1,505 and for a typical RARP case was $ 2,260. RARP thus carried a cost premium of $755/case in disposable materials alone. The most expensive disposable items used in RARP were the Da Vinci instruments. The most expensive disposable used in LRP was the harmonic scalpel ($417/case). Costs for LRP could be decreased by another $180/case if certain optional instruments were either not used or replaced by reusables (e.g. screw trocars), whereas the costs for RARP may have been underestimated given that on occasion, an instrument may fail prior to its 10-case lifespan.
Conclusions: RARP presents higher variable costs (supplies) to an operating room than does LRP by more than $750/case. This consideration may be of increasing importance given the difficult economic environment facing United States healthcare at present.

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