Study objective: To compare the safety and cost-effectiveness of disposable and nondisposable infraumbilical laparoscopic cannulas.
Design: Retrospective review of consecutive laparoscopic procedures performed from July 1, 1988, to June 30, 1994.
Setting: A university-affiliated hospital. Patients. The 10,459 consecutive women who underwent laparoscopies.
Interventions: A 10-mm disposable cannula was used in 529 laparoscopies and a nondisposable cannula in 9930, based on physician preference.
Measurements and main results: The only intraabdominal injuries associated with insertion of disposable and nondisposable cannulas were bowel injuries in one and three patients, respectively. The injury rates for the instruments were 19 and 3/10,000 cases, respectively, but were not statistically different (P <0.05, Fisher's two-tail exact test). The hospital cost per disposable cannula in 1994 was $63.71; the cost per procedure with the nondisposable cannula was amortized and was less than $1.35, including maintenance.
Conclusion: Disposable cannulas were not cost effective and were associated with a higher but not statistically significant complication rate. Therefore, the more expensive disposable cannulas are not recommended.