Evidence map›Paper›PMID 42377528›Full record

SynthesisSurgical endoscopy2026

Economic impact of disposable versus reusable instruments in minimally invasive surgery: a systematic review.

Pieter J W Greve, Masie Rahimi, Freek Daams, Jan Willem M Greve, Jaap H Bonjer, Tim Horeman, Marlies P Schijven

Abstract readSystematic ReviewComparative Study
In one paragraph

Synthesis 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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Pieter J W GreveDept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, The Netherlands.
Masie RahimiDept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, The Netherlands.
Freek DaamsDept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, The Netherlands.
Jan Willem M GreveMaastricht NUTRIM - Institute of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands.
Jaap H BonjerDept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, The Netherlands.
Tim HoremanDepartment of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
Marlies P SchijvenDept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, The Netherlands. m.p.schijven@amsterdamumc.nl.ORCID http://orcid.org/0000-0001-7013-0116

Funding

Nederlandse Organisatie voor Wetenschappelijk Onderzoek KICH1.ST03.21.002
6 · The paper itself

Abstract

objectiveTo systematically evaluate the economic impact of disposable versus reusable instruments in minimally invasive surgery (MIS), and to summarize the limited available evidence on environmental impact.

backgroundThe increasing use of disposable instruments in MIS has raised concerns regarding healthcare costs and environmental sustainability. While reusable instruments may reduce per-procedure costs and waste, their economic and environmental performance is influenced by procedure type, workflow, and reprocessing requirements. Evidence integrating these factors across surgical specialties remains limited.

methodsA systematic review was conducted in accordance with PRISMA guidelines. Studies published since 2014 comparing disposable and reusable instruments in MIS were identified using predefined PICOS criteria. Data extraction focused on cost components, including instrument costs, sterilization, operating room time, and total procedural costs. Environmental outcomes were recorded when available.

resultsNine studies encompassing 4,724 procedures across multiple surgical specialties met inclusion criteria. In general surgery, reusable instruments were consistently associated with lower per-procedure costs, with reported savings ranging from $16 to $388. In selected subspecialties, including gynecology, thoracic surgery, and spinal surgery, disposable instruments were associated with reduced operative time, indirectly lowering total costs in specific settings. Only one included study directly assessed environmental impact, providing limited, low-level evidence that reusable instruments may confer environmental benefit primarily when used repeatedly.

conclusionReusable instruments appear to be associated with lower per-procedure costs in general surgery, while disposable instruments may offer context-specific economic advantages in selected subspecialties. Conclusions regarding environmental impact are limited by the scarcity of primary data. Future studies incorporating standardized cost definitions and robust environmental assessments, including life-cycle analyses, are needed to support evidence-based and sustainable instrument selection in MIS.

Indexed as

Disposable EquipmentEquipment ReuseMinimally Invasive Surgical ProceduresSurgical InstrumentsCost-Benefit AnalysisHumansCost analysisDisposable instrumentsEnvironmental sustainabilityLife-cycle assessmentMinimally invasive surgeryReusable instrumentsSurgical instruments

Identifiers

PMID42377528
PMCPMC13161267

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Registered trials

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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.