ArticleSurgical endoscopy2026
From procurement to disposal: a framework for an activity-based cost analysis of reusable and disposable trocars in laparoscopic cholecystectomy.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOperating rooms are responsible for a substantial share of hospital waste, with laparoscopic procedures being particularly resource-intensive due to their reliance on disposable instruments. In a laparoscopic cholecystectomy (LC), disposable products account for approximately 40% of emissions, with trocars being key contributors. Reusable trocars lower environmental impact and evidence suggests that costs can be reduced. Accordingly, this study compares the costs of reusable versus disposable trocars during LC in a Dutch academic hospital and develops an adaptable framework for cost evaluation in other healthcare settings.
methodsAn activity-based costing analysis was conducted to estimate the per-procedure costs (i.e. per LC), including the costs for acquisition, sterilisation, storage, and waste disposal. This was based on an LC using four trocars: two 5 mm and two 12 mm trocars. Resource use was based on expert input, and unit costs were obtained from hospital procurement data. The costing framework was designed to be adaptable to different institutional contexts. Uncertainty in the cost difference was assessed using probabilistic sensitivity analysis with 1000 Monte Carlo simulations, alongside one-way, two-way, and scenario analyses.
resultsAcquisition costs per LC were substantially lower for reusable trocars (€8.15) than for disposable trocars (€89.55). Although reusable trocars incurred sterilisation costs (€13.31 per procedure), total costs, including all activities involved in LC, remained lower (€683.00 vs €751.43), resulting in savings of €68.80 per procedure. Reusable trocars were cost-saving in all sensitivity analyses. Estimated annual savings were €10,264 at institutional level (based on 150 procedures) and €1.54 million nationally (based on 22,500 procedures).
conclusionReusable trocars are cost-saving compared to disposable trocars in LC. The adaptable activity-based costing framework developed in this study enables healthcare institutions to evaluate the economic impact of reusable versus disposable surgical instruments within their own settings, supporting both cost reduction and environmental sustainability.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.