Multi-center Survey of the Use of Disposable Surgical Materials in Total Gastrectomy and Lower Anterior Resection

Kikuo Koufuji, Kazuo Shirouzu, Yutaka Ogata¹⁾, Yuichi Yamashita²⁾, Shingo Kameoka³⁾, Kenji Ogawa⁴⁾, Mituo Shimada⁵⁾ and Hideki Yasuda⁶⁾

Department of Surgery, Kurume University School of Medicine
Department of Surgery, Medical Center of Kurume University School¹⁾
Department of Gastroenterological Surgery, Fukuoka University School of Medicine²⁾
Department of Second Surgery, Tokyo Women's Medical University³⁾
Department of Surgery, Tokyo Women's Medical Hospital Center East⁴⁾
Department of Digestive and Pediatric Surgery, the University of Tokushima Faculty of Medicine⁵⁾
Department of Surgery, Teikyo University Chiba Medical Center⁶⁾

Introduction: Recently, the frequency of use of disposable surgical materials is increasing, however, multi-center survey on those in digestive surgery has almost never been done. We investigated the current status of their use for total gastrectomy and for lower anterior resection. Methods: The study group comprised 156 patients who underwent total gastrectomy in 20 participating institutions and 109 patients who underwent lower anterior resection in 14 participating institutions. The disposable surgical materials were divided into 7 items, such as sheets and gowns, threads, needles and threads, materials for drainage, devices for wound protect and retract, wound dressing materials and devices of wound closure. The median cost of each material was calculated. Results: The cost of needles and treads was most expensive in all of the 7 items both operations. The median cost for disposable surgical materials was 72,385 yen in total gastrectomy and 57,725 yen in lower anterior resection. The percentage of the median cost of disposable surgical materials in the surgical fee was 12.4% in total gastrectomy and 13.1% in lower anterior resection. Discussion: It has been clarified that the cost of disposable surgical materials occupy more than 10 percent of the surgical fee for both total gastrectomy and lower anterior resection. Based upon the concept of separating the technical fee and device cost, a separating the health insurance claims of the cost of disposable surgical materials and surgical fee is recommended.

Key words
disposable surgical materials, surgical fee, total gastrectomy, lower anterior resection

Reprint requests
Kikuo Koufuji Department of Surgery, Kurume University School of Medicine
67 Asahimachi, Kurume, 830-0011 JAPAN

Accepted
December 16, 2009

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