The impact of single-use digital flexible cystoscope for double J removal on hospital costs and work organization: A multicentric evaluation

Author:

Oderda Marco1ORCID,Amato Antonio2,de la Rosette Jean3,Doizi Steve4,Estrade Vincent5,Falcone Marco1,Grey Ben6,Knudsen Bodo7,Olsburgh Jonathon8,Pietropaolo Amelia9,Rukin Nick10,Sedigh Omidreza1,Saeed Alhamri11,Somani Bhaskar K9,Gontero Paolo1

Affiliation:

1. Dept. of Surgical Sciences, Division of Urology, Città della Salute e della Scienza di Torino – Molinette Hospital, University of Torino, Torino, Italy

2. Dept of Renal Transplantation, Civico Hospital, Palermo, Italy

3. Dept of Urology, Istanbul Medipol University, Istanbul, Turkey

4. Dept of Urology, Tenon Hospital, Paris, France

5. Division of Urology, CH Angouleme, Angouleme, France

6. Dept of Urology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK

7. Dept of Urology, Ohio State University Wexner Medical Center, Columbus, OH, USA

8. Dept of Urology, Guy’s Hospital, London, UK

9. Dept of Urology, University Hospital Southampton, Southampton, UK

10. Dept of Urology, Redcliffe Hospital, Redcliffe, QLD, Australia

11. Dept. of Urology, Dept. of Surgery, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia

Abstract

Background: Isiris-α® is a single-use digital flexible cystoscope with an integrated grasper designed for double J (DJ) stent removal. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of stent removals performed with Isiris®-α in different hospitals and health systems, as compared to other DJ removal procedures. Methods: After gathering 10 institutions worldwide with experience on Isiris-α®, we performed an analysis of the reported costs of DJ removal with Isiris-α®, as compared to the traditional reusable equipment used in each institution. The cost evaluation included instrument purchase, Endoscopic Room (EnR)/ Operatory Room (OR) occupancy, medical staff, instrument disposal, maintenance, repairs, decontamination or sterilization of reusable devices. Results: The main factor affecting the costs of the procedure was OR/EnR occupancy. Decontamination and sterilization accounted for a less important part of total costs. Isiris-α® was more profitable in institutions where DJ removal is usually performed in the EnR/OR, allowing to transfer the procedure to outpatient clinic, with a significant cost saving and EnR/OR time saving to be allocated to other activities. In the only institution where DJ removal was already performed in outpatient clinics, there is a slight cost difference in favor of reusable instruments in high-volume institutions, given a sufficient number to guarantee the turnover. Conclusion: Isiris-α® leads to significant cost benefit in the institutions where DJ removal is routinely performed in EnR/OR, and brings significant improvement in organization, cost impact and turnover.

Funder

Coloplast

Publisher

SAGE Publications

Subject

General Medicine

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