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Excess use of surgical supplies in minimally invasive benign gynecology surgery: an observational study - 26/07/24

Doi : 10.1016/j.ajog.2024.05.008 
Aya Mohr-Sasson, MD a, b, , Madison Aycock, BA a, Noel Higgason, BA a, Mason Hui, MO a, Asha Bhalwal, MD a, Randa Jalloul, MD a, Mateo G. Leon, MD a, Olivia Dziadek, MD a, Alvaro Montealegre, MD a
a Advanced Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology & Reproductive Sciences, McGovern Medical School at The University of Texas Health Science Center, Houston, TX 
b Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel 

Corresponding author: Aya Mohr-Sasson, MD.

Abstract

Background

Single-use materials and equipment are regularly opened by the surgical team during procedures but left unused, potentially resulting in superfluous costs and excess environmental waste.

Objective

This study aimed to estimate the excess use of surgical supplies in minimally invasive benign gynecologic surgeries.

Study Design

This is a prospective observational study conducted at a university-affiliated single tertiary medical center. Designated study personnel were assigned to observe surgical procedures performed during July to September 2022. Surgical teams were observed while performing surgeries for benign indications. The teams were not informed of the purpose of the observation to avoid potential bias. Disposable materials and equipment opened during the procedure were documented. Excess supplies were defined as those opened but left unused before being discarded. Costs per item of the excess supplies were estimated on the basis of material and equipment costs provided by the hospital.

Results

A total of 99 surgeries were observed, including laparoscopic (32%), robotic (39%), hysteroscopic (14%), vaginal (11%), and laparotomy procedures (3%). Excess use of surgical supplies was documented in all but one procedure. The total cost across all surgeries reached $6357. The contained tissue extraction bag was the most expensive item not used (Applied Medical, Rancho Santa Margarita, CA; $390 per unit) in 4 procedures, contributing 25.54% to the total cost. Raytec was the most common surgical waste, with a total of n=583 opened but unused (average n=5.95 per surgery). A significant difference was found in the rate of excess supplies across the surgical approaches, with robotic surgery contributing 52.19% of the total cost (P=.01).

Conclusion

Excess use of disposable materials and equipment is common in minimally invasive benign gynecologic surgeries and contributes to superfluous costs and excess environmental waste. It is predominantly attributed to the opening of inexpensive materials that are left unused during the procedure. Increased awareness of costs and generated waste may reduce excess use of surgical supplies and should be further explored in future research.

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Key words : disposable materials, excess use, gynecologic surgeries, minimally invasive surgery, surgical waste


Plan


 The authors report no conflict of interest.
 The study protocol has received a waiver from the Institutional Review Board.
 Presented orally at the 50th annual meeting of the Society of Gynecology Surgeons, Orlando, FL, March 24–27, 2024.
 Cite this article as: Mohr-Sasson A, Aycock M, Higgason N, et al. Excess use of surgical supplies in minimally invasive benign gynecology surgery: an observational study. Am J Obstet Gynecol 2024;231:273.e1-7.


© 2024  Elsevier Inc. Tous droits réservés.
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Vol 231 - N° 2

P. 273.e1-273.e7 - août 2024 Retour au numéro
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